- |||||||||| Remicade (infliximab) / Mitsubishi Tanabe, J&J, Opdivo (nivolumab) / Ono Pharma, BMS
A Fatal Case of Multisystem Organ Dysfunction Secondary to Immune Check Point Inhibitor Use (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area G) - Mar 15, 2020 - Abstract #ATS2020ATS_5431;
Corticosteroids are first line of treatment. For steroid resistant cases, immunomodulatory agents, such as infliximab, other TNF inhibitors, anti-thymocyte globulin, or intravenous immunoglobulin and plasmapharesis may be required (1).
- |||||||||| prednisolone / Generic mfg.
Journal: Primary leptomeningeal lymphoma with oculomotor paralysis as the initial presentation (Pubmed Central) - Mar 14, 2020
Due to a lack of abnormal findings on plain magnetic resonance imaging (MRI) and laboratory examination, prednisolone therapy was initiated, and ocular myasthenia gravis and ocular symptoms subjectively improved...Primary leptomeningeal lymphoma is a rare form of primary central nervous system lymphoma without simultaneous parenchymal brain lesions. Clinicians should be aware of this form of lymphoma and carefully monitor its possible occurrence, even when patients are already being treated for other neurological diseases.
- |||||||||| Clinical, Journal: The clinical spectrum of the congenital myasthenic syndrome resulting from COL13A1 mutations. (Pubmed Central) - Mar 13, 2020
Disease course improves gradually over time, which could be consistent with the less prominent role of COL13A1 once the neuromuscular junction is mature. This report emphasizes the role of collagens at the human muscle endplate and should facilitate the recognition of this disorder, which can benefit from pharmacological treatment.
- |||||||||| Clinical, Review, Journal, Adverse events, Checkpoint inhibition: Clinical Characteristics and Treatment of Immune-Related Adverse Events of Immune Checkpoint Inhibitors. (Pubmed Central) - Mar 13, 2020
Treatment under the supervision of multidisciplinary specialists is also essential, because the symptoms and treatments of irAEs could involve many organs. Thus, this review focuses on the mechanism, clinical presentation, incidence, and treatment of various irAEs.
- |||||||||| Rituxan (rituximab) / Roche
Enrollment closed, Trial completion date, Trial primary completion date: A Study Evaluating the Safety and Efficacy of Rituximab in Patients With Myasthenia Gravis (clinicaltrials.gov) - Mar 13, 2020
P3, N=47, Active, not recruiting,
Thus, this review focuses on the mechanism, clinical presentation, incidence, and treatment of various irAEs. Recruiting --> Active, not recruiting | Trial completion date: Dec 2020 --> Jun 2021 | Trial primary completion date: Jun 2020 --> Jan 2021
- |||||||||| Trial completion, Trial completion date, Trial primary completion date: Rhythmic Auditory Stimulation and Walking Speed in the 6-minute Walk Test (clinicaltrials.gov) - Mar 12, 2020
P=N/A, N=48, Completed,
Recruiting --> Active, not recruiting | Trial completion date: Dec 2020 --> Jun 2021 | Trial primary completion date: Jun 2020 --> Jan 2021 Recruiting --> Completed | Trial completion date: Oct 2021 --> Jan 2020 | Trial primary completion date: Oct 2020 --> Jan 2020
- |||||||||| Journal: Management of Insomnia and Anxiety in Myasthenia Gravis. (Pubmed Central) - Mar 10, 2020
Unfortunately, selecting an appropriate medication for treatment of psychiatric comorbidities can prove to be challenging for providers given the unique pharmacologic constraints that myasthenia gravis presents. The authors present the following clinical vignette and accompanying discussion in an attempt to highlight the special considerations that must be taken into account when treating anxiety and insomnia in patients with myasthenia gravis, as well as to provide an overview of available medication options through the lens of existing constraints.
- |||||||||| Clinical, Journal: Myasthenia gravis. Register of 190 cases in a single center (Pubmed Central) - Mar 8, 2020
Clinical outcome was relatively good; more than half of cases were in remission or minimal manifestations at the last visit. The majority of patients required immunosuppression to control the symptoms, 78% received corticosteroids and 48%, a non-steroidal immunosuppressant.
- |||||||||| [VIRTUAL] THE HUMANISTIC AND ECONOMIC BURDEN OF MYASTHENIA GRAVIS (MG) - A DEBILITATING & COSTLY DISEASE () - Mar 8, 2020 - Abstract #ISPOR2020ISPOR_391;
A US claims database found annual costs to be approximately 4 times higher in refractory vs. non-refractory patients ($109,004 vs. $24,196, p<0.001), possibly related to a higher use of IVig/PLEX, costly therapies according to economic models. CONCLUSIONS : Novel treatment strategies are necessitated to help control rising costs and alleviate the humanistic burden associated with MG, especially in refractory patients.
- |||||||||| Clinical, Journal: An Overlapping Case of Miller Fisher Syndrome and the Pharyngeal-Cervical-Brachial Variant of Guillain-Barré Syndrome. (Pubmed Central) - Mar 7, 2020
We present a rare overlapping case of Miller Fisher syndrome and the pharyngeal-cervical-brachial variant of Guillain-Barré syndrome. The overlap of Miller Fisher syndrome and pharyngeal-cervical-brachial variants of Guillain-Barré syndrome are rarely described in the literature but should be considered when multiple cranial nerves are involved with normal neuroimaging results, even with normal cerebrospinal fluid analysis.Due to similar clinical presentation, a misdiagnosis of cerebral ischaemia, botulism or ocular myasthenia gravis can delay treatment and put patients at risk.In its natural history, this syndrome evolves to respiratory arrest and death, but with accurate diagnosis and prompt treatment, the prognosis improves considerably.
- |||||||||| Enrollment open, Trial completion date: A Pilot Study to Explore the Role of Gut Flora in Myasthenia Gravis (clinicaltrials.gov) - Mar 6, 2020
P=N/A, N=100, Recruiting,
The overlap of Miller Fisher syndrome and pharyngeal-cervical-brachial variants of Guillain-Barré syndrome are rarely described in the literature but should be considered when multiple cranial nerves are involved with normal neuroimaging results, even with normal cerebrospinal fluid analysis.Due to similar clinical presentation, a misdiagnosis of cerebral ischaemia, botulism or ocular myasthenia gravis can delay treatment and put patients at risk.In its natural history, this syndrome evolves to respiratory arrest and death, but with accurate diagnosis and prompt treatment, the prognosis improves considerably. Not yet recruiting --> Recruiting | Trial completion date: Mar 2023 --> Jul 2023
- |||||||||| Journal: Low prevalence of Merkel cell polyomavirus in human epithelial thymic tumors. (Pubmed Central) - Mar 5, 2020
MCPyV DNA and MCPyV protein expression can be detected in human epithelial thymoma; however, to a far lesser extent than HPyV7. Our data strongly indicate that because of its infrequent detection and weak expression, MCPyV is unlikely to play an important role in the etiopathogenesis of human thymomas.
- |||||||||| Review, Journal: Receptor autoimmunity: diagnostic and therapeutic implications. (Pubmed Central) - Mar 5, 2020
The measurement of autoantibodies is also relevant for differential diagnosis of autoimmune and non-autoimmune forms with similar symptoms. From the methodological point of view, quantitative immunoassay methods of measurement should be preferred over semi-quantitative ones, for the capacity of the first class of methods to define precisely the reference ranges and decision levels overcoming the measurement uncertainty of semi-quantitative methods.
- |||||||||| carbamazepine / Generic mfg.
Journal: Myotonic Myopathy With Secondary Joint and Skeletal Anomalies From the c.2386C>G, p.L769V Mutation in SCN4A. (Pubmed Central) - Mar 3, 2020
The phenotype was manifest at birth with arthrogryposis multiplex congenita, severe episodes of bronchospasm that responded immediately to carbamazepine therapy, and electromyographic evidence of widespread myotonia...Computer simulations of muscle excitability reveal a strong predisposition to myotonia with exceptionally prolonged bursts of discharges, when the L796V defects are included. We propose L769V is a pathogenic variant, that along with other cases in the literature, defines a new dominant SCN4A disorder of myotonic myopathy with secondary congenital joint and skeletal involvement.
- |||||||||| Journal: Myasthenia gravis and large granular lymphocytic leukemia. (Pubmed Central) - Mar 2, 2020
We propose L769V is a pathogenic variant, that along with other cases in the literature, defines a new dominant SCN4A disorder of myotonic myopathy with secondary congenital joint and skeletal involvement. No abstract available
- |||||||||| [VIRTUAL] CbW04: Myasthenia gravis: diagnostic mimics (CbW Room) - Mar 2, 2020 - Abstract #EAN2020EAN_144;
The clinical sign of fluctuating muscle weakness is an indication of the diagnosis of Myasthenia gravis, so it could be misleading if an uncommon differential is not considered. Specific symptoms and signs could help define diagnosis, perform appropriate tests and avoid unnecessary treatments.
- |||||||||| prednisolone / Generic mfg.
Clinical, Observational data, Journal: Prevalence and Associated Factors of Depressive Symptoms in Patients with Myasthenia Gravis: A Cross-Sectional Study of Two Tertiary Hospitals in Riyadh, Saudi Arabia. (Pubmed Central) - Mar 2, 2020
Data were collected with a two-part standardized questionnaire: the first part included data on sociodemographic and clinical features of MG including disease type and duration, therapies, prednisolone dose, time of the last relapse, previous critical care unit admissions, MG status (controlled, partially controlled, or uncontrolled), and comorbid diseases; the second part included items from the previously validated Arabic version of the Patient Health Questionnaire-9 (PHQ-9)...Approximately a quarter of MG patients have depression. Achieving a minimal manifestation or better MG status may decrease the depression rate in these patients.
- |||||||||| Review, Journal, PD(L)-1 Biomarker, IO Biomarker: Emerging PD-1 and PD-1L inhibitors-associated myopathy with a characteristic histopathological pattern. (Pubmed Central) - Mar 2, 2020
A large component of macrophages resembling granulomas seems to be the pathological hallmark of the syndrome. Further information is required to understand the wide spectrum of immune-related adverse events involving the muscle during or after treatment with anti-PD-1 inhibitors, but the pathological picture seems to be characteristic.
- |||||||||| efgartigimod IV (ARGX-113 IV) / argenx, Broteio
Preclinical, Journal: Efgartigimod improves muscle weakness in a mouse model for muscle-specific kinase myasthenia gravis. (Pubmed Central) - Feb 29, 2020
These synaptic improvements may well become more explicit upon longer drug exposure. In conclusion, our study shows that efgartigimod has clear therapeutic potential in MuSK myasthenia gravis and forms an exciting candidate drug for many autoantibody-mediated neurological and other disorders.
- |||||||||| Journal: Myasthenia gravis, Guillain-Barré syndrome, or both? (Pubmed Central) - Feb 25, 2020
His medical history revealed a post-infectious acute onset of weakness in four extremities, difficulty in swallowing and respiratory failure, which was compatible with a myasthenic crisis; however, his nerve conduction studies and albuminocytologic dissociation at the time were compatible with GBS. With this case report, we aimed to mention this rare coincidental state, discuss possible diagnoses and review all other similar cases in the literature with their main features.
- |||||||||| Journal: Diagnosis and surgical management of isolated inferior oblique palsy. (Pubmed Central) - Feb 25, 2020
The acquired cases included vascular, orbital trauma/surgery and myasthenia gravis. Weakening of the ipsilateral superior oblique muscle and/or contralateral superior rectus recession often resulted in favorable surgical outcomes with a surgical success rate of 61.5%.
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