Myasthenia Gravis
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  • ||||||||||  Keytruda (pembrolizumab) / Merck (MSD), Opdivo (nivolumab) / BMS
    Myositis-myasthenia gravis overlap syndrome under immune checkpoint monotherapy (Terminal 4) -  Jul 11, 2024 - Abstract #ADO2024ADO_242;    
    The 73-year-old patient received nivolumab for pulmonary and lymphogenous metastatic malignant melanoma, NMM, TD 10 mm with ulceration, occipital, BRAF mutated...In both cases, repeated high-dose prednisolone pulse therapies were administered over several weeks in combination with the administration of immunoglobulins, and in one case mycophenolate mofetil was initiated...The stage IV patient, who suffered massive tumor progression with disseminated pulmonary, peritoneal and also cerebral metastases during the therapy break, was successfully placed on systemic therapy with BRAF-MEK inhibitors after radiation of the cerebral metastases in the presence of a proven BRAF mutation. With these two case reports, we would like to point out the problems of assessing cardiac involvement and the therapeutic difficulties of this therapy complication, which is also lethal in a high percentage of cases (1).
  • ||||||||||  Mavenclad (cladribine) / EMD Serono
    Trial completion date, Trial primary completion date:  Efficacy and Safety of a New Formulation of Oral Cladribine Compared With Placebo in Participants With Generalized Myasthenia Gravis (MyClad) (clinicaltrials.gov) -  Jul 11, 2024   
    P3,  N=240, Recruiting, 
    With these two case reports, we would like to point out the problems of assessing cardiac involvement and the therapeutic difficulties of this therapy complication, which is also lethal in a high percentage of cases (1). Trial completion date: Feb 2031 --> Jul 2030 | Trial primary completion date: Feb 2029 --> May 2028
  • ||||||||||  Journal:  A perplexing case report of concomitant multiple sclerosis and myasthenia gravis. (Pubmed Central) -  Jul 11, 2024   
    Considering the similar immunological background of the two diseases, ideally, a single therapeutic modality could be used for management. This will hopefully simplify the patient's treatment regimen and may ultimately reduce the treatment cost and patient burden.
  • ||||||||||  B007 / Shanghai Pharma
    Enrollment open:  SPH-B007-303: A Clinical Study of B007 in the Treatment of Generalized Myasthenia Gravis. (clinicaltrials.gov) -  Jul 11, 2024   
    P2/3,  N=104, Recruiting, 
    Novel medications are introduced and conducted to the specific pathophysiologic mechanisms of the disease, and they are used primarily in the refractory MG. Not yet recruiting --> Recruiting
  • ||||||||||  Rystiggo (rozanolixizumab-noli) / UCB
    Journal:  Clinical meaningfulness and psychometric robustness of the MG Symptoms PRO scales in clinical trials in adults with myasthenia gravis. (Pubmed Central) -  Jul 9, 2024   
    P3
    Data from the MycarinG study, a phase 3 study of rozanolixizumab in patients with generalized MG who experience moderate to severe symptoms (ClinicalTrials.gov Identifier: NCT03971422) were analyzed with both classical test theory (CTT) and Rasch measurement theory (RMT)...Benchmarks are also proposed for the interpretation of group-level results. The strong psychometric performance of the MG Symptoms PRO scales and the information generated to guide its interpretation supports its use in clinical trials for demonstrating the clinical benefits of new treatments targeting core symptoms of MG (muscle weakness fatigability, physical fatigue, bulbar muscle weakness, respiratory muscle weakness, and ocular muscle weakness).
  • ||||||||||  Journal:  Child Neurology: Common Occurrence of Narcolepsy Type 1 and Myasthenia Gravis. (Pubmed Central) -  Jul 8, 2024   
    Narcolepsy with cataplexy and myasthenia gravis are both chronic neurologic conditions causing symptoms of muscle weakness, often affecting facial muscles, and have both been attributed to an immune-mediated etiology. We report an adolescent girl diagnosed with both conditions and discuss possible shared mechanisms and the diagnostic challenges presented by her case to inform and aid clinicians managing children and young people with these rare conditions.
  • ||||||||||  Rituxan (rituximab) / Roche
    Journal:  A Case Report of MuSK Antibody-Positive Myasthenia Gravis. (Pubmed Central) -  Jul 8, 2024   
    Even though MuSK-MG is rare, it is an important diagnostic consideration, particularly in patients presenting with atypical symptoms or lacking AChR antibodies and in patients who have a poor response to conventional treatment. Acetylcholinesterase inhibitors, corticosteroids, immunosuppressants, and newer biologic agents targeting B cells are some of the treatments.
  • ||||||||||  zonisamide / Generic mfg., pregabalin / Generic mfg., pramipexole IR / Generic mfg.
    Parkinson's disease and Myasthenia Gravis: a case report and literature review (Poster Hall (Exhibit Hall A)) -  Jul 8, 2024 - Abstract #MDSCongress2024MDS_Congress_192;    
    Co-occurrence is rare, with limited cases reported since 1987(3). Most cases involve males aged 55-95, with PD preceding MG by 8 months to 20 years.
  • ||||||||||  Journal:  Neuro-ophthalmic complications of modern anti-cancer drugs. (Pubmed Central) -  Jul 3, 2024   
    The neuro-ophthalmic complications of modern anti-cancer drugs can limit or necessitate the withdrawal of these life-prolonging medications. Ophthalmologists should be alert for neuro-ophthalmic complications in these medications to facilitate prompt diagnosis and treatment and reduce the risk of severe and permanent consequences.
  • ||||||||||  Near Fiber Segment Jitter in the Diagnosis of Myasthenia Gravis (B7) -  Jul 2, 2024 - Abstract #EAN2024EAN_3137;    
    NFEMG performs well in diagnosing MG. Due to the ease of application to routine EMG and the minimal need for training, NFEMG may represent an effective screen prior to referring for SFEMG or as a viable alternative diagnostic test when SFEMG is not available, potentially addressing a significant global healthcare disparity.
  • ||||||||||  BCMA-targeted CAR T cell therapy in the management of refractory myasthenia gravis (B7) -  Jul 2, 2024 - Abstract #EAN2024EAN_3135;    
    Due to the ease of application to routine EMG and the minimal need for training, NFEMG may represent an effective screen prior to referring for SFEMG or as a viable alternative diagnostic test when SFEMG is not available, potentially addressing a significant global healthcare disparity. In conclusion, the study demonstrated that BCMAtargeted CAR T therapy is a safe and effective treatment for refractory MG.
  • ||||||||||  Predictive serological biomarkers of disease outcome in myasthenia gravis (A5) -  Jul 2, 2024 - Abstract #EAN2024EAN_2984;    
    Most TEAEs were mild to moderate in severity and did not increase in frequency with recurrent dosing. The adult/fetal AChR immunoreactivity ratio may constitute a biological marker predictive of AChR- MG outcome and should be investigated in larger prospective studies.
  • ||||||||||  Rituxan (rituximab) / Roche
    Anti-MuSK Antibody Resurgence Precedes Exacerbation (A5) -  Jul 2, 2024 - Abstract #EAN2024EAN_2982;    
    The adult/fetal AChR immunoreactivity ratio may constitute a biological marker predictive of AChR- MG outcome and should be investigated in larger prospective studies. Post- rituximab treatment, IgG4 levels decreased in the first month, remaining low for 6
  • ||||||||||  prednisone / Generic mfg., cyclosporine / Generic mfg., azathioprine / Generic mfg.
    A retrospective multicenter study in MuSK myasthenia gravis patients with and without general immunosuppression (A5) -  Jul 2, 2024 - Abstract #EAN2024EAN_2981;    
    Based on our observations, we conclude that MuSK- MG patients improve clinically with general immunosuppression but may require further treatment to reach remission. Inter- assay variability may hide individual changes of MuSK IgG4 levels; therefore longitudinal testing of individual patients may be clinically more useful than single measurements.
  • ||||||||||  Vyvgart (efgartigimod alfa-fcab) / argenx, Broteio
    The Therapeutic Effect of Efgartigimod in Autoimmune Encephalitis (A5) -  Jul 2, 2024 - Abstract #EAN2024EAN_2896;    
    Efgartigimod shows promise as a safe and effective treatment for autoimmune encephalitis. This pioneering report highlights its potential as an innovative therapeutic option for this condition.
  • ||||||||||  Vyvgart (efgartigimod alfa-fcab) / argenx, Broteio
    Evaluating the effect of Efgartigimod in Myasthenia Gravis Crisis (A5) -  Jul 2, 2024 - Abstract #EAN2024EAN_2894;    
    The efgartigimod group shows shorter hospital stays and mechanical ventilation durations and the potential to improve muscle weakness in the short term. The trend suggests that efgartigimod could potentially offer advantages in managing the MG crisis.
  • ||||||||||  Single Fiber EMG in the diagnostic workup of diplopia and ptosis (A5) -  Jul 2, 2024 - Abstract #EAN2024EAN_2890;    
    Use of high-dose OCS in patients with MG was associated with adverse outcomes including increased rates of long-term hospitalizations and clinical complications. Our findings suggest that SFEMG is a valuable tool in the diagnostic workup of diplopia and ptosis and in the differential diagnosis of MG, especially in seronegative MG cases and in those with negative RNS results.
  • ||||||||||  Entyvio (vedolizumab) / Takeda, Rituxan (rituximab) / Roche
    Novel Approaches for Immune-mediated Chronic Intestinal Pseudo-obstruction: a Case Series (A5) -  Jul 2, 2024 - Abstract #EAN2024EAN_2889;    
    Our findings underscore the potential efficacy of rituximab and vedolizumab in the management of neurologic autoimmune gastrointestinal dysmotility with chronic intestinal pseudoobstruction, particularly in refractory cases. Although a larger sample is needed, these interventions should be considered valuable options in the therapeutic landscape for such patients.
  • ||||||||||  Vyvgart (efgartigimod alfa-fcab) / argenx, Broteio
    Real world experience of Efgartigimod in a single UK centre  (B7) -  Jul 2, 2024 - Abstract #EAN2024EAN_2865;    
    50% had received Rituximab. Efgartigimod is an effective and well tolerated treatment in patients with refractory gMG.