Myasthenia Gravis
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  • ||||||||||  Keytruda (pembrolizumab) / Merck (MSD)
    Clinical, Journal:  Pembrolizumab-related systemic myositis involving ocular and hindneck muscles resembling myasthenic gravis: a case report. (Pubmed Central) -  Dec 1, 2019   
    Idiopathic inflammatory myositis evolving levator palpebrae superioris and ocular muscles is quite rare; however, myositis due to immune-checkpoint inhibitors may preferentially involve these muscles. This case report will alert physicians to the possibility of systemic inflammatory myopathy evolving levator palpebrae superioris, extraocular and hindneck muscles mimicking MG due to pembrolizumab.
  • ||||||||||  methylprednisolone / Generic mfg., Rituxan (rituximab) / Roche, Biogen
    Rituximab for the Treatment of Intractable Epilepsy Due to Autoimmune Encephalitis: Case Series (Hall E) -  Nov 28, 2019 - Abstract #AES2019AES_824;    
    There is no accepted treatment for these disorders, but typical approaches involve chronic high-dose steroids (often for months or years), methotrexate or mycophenolate...She initially responded to high-dose prednisone (1 mg/kg), but, upon tapering steroids, developed recurrent epilepsy and dementia...EEG showed left fronto-temporal sharp waves with intermittent slowing that did not respond to IVIG or IV methylprednisolone, but rapidly responded to a single dose of rituximab...Also, tumors may not be immediately apparent in paraneoplastic syndromes. Further studies are needed to establish safety and efficacy.
  • ||||||||||  Rituxan (rituximab) / Roche, Biogen
    Brain-Responsive Neurostimulation Treatment in Five Patients with Autoimmune Epilepsy (Hall E) -  Nov 28, 2019 - Abstract #AES2019AES_334;    
    Patient 4 failed 7 ASDs, steroid, IVIG, Plasma exchange and Rituximab treatment...She was treated with immunotherapy (steroid, IVIG and Cellcept) as well as Mestinon and thymomectomy...Conclustions Treatment with the RNS System was safe and lead to excellent results in these 5 cases of medically refractory AE. The data provided insights on seizure lateralization, seizure timing/patterns and response to immunotherapy treatment which would have otherwise not been possible.
  • ||||||||||  Clinical, Journal:  Fecal microbiota profile in a group of myasthenia gravis patients. (Pubmed Central) -  Nov 28, 2019   
    In contrast, no statistically significant differences were found between MG patients and the control group in the bifidobacterial population at the species level or in short chain fatty acids profiles. Our data indicates an altered fecal microbiota pattern in MG patients and point out at specific microbiota targets for intervention in this population.
  • ||||||||||  Journal:  Autoimmune diseases in autoimmune atrophic gastritis. (Pubmed Central) -  Nov 27, 2019   
    Interestingly, however, celiac disease, another frequent autoimmune condition, seems to play a protective role for autoimmune atrophic gastritis. The elevated prevalence of autoimmune disease clustering should prompt the clinicial to exclude concomitant autoimmune conditions upon diagnosis of any autoimmune disease.
  • ||||||||||  Journal:  Leukoencephalopathy due to variants in GFPT1-associated congenital myasthenic syndrome. (Pubmed Central) -  Nov 27, 2019   
    GFPT1 variants and defects in other enzymes of this pathway have previously been associated with congenital myasthenia. These findings identify leukoencephalopathy as a previously unrecognized phenotype in GFPT1-related disease and suggest that mitochondrial dysfunction could contribute to this disorder.
  • ||||||||||  tacrolimus / Generic Mfg.
    Journal:  IL-2 gene polymorphisms affect tacrolimus response in myasthenia gravis. (Pubmed Central) -  Nov 27, 2019   
    These findings identify leukoencephalopathy as a previously unrecognized phenotype in GFPT1-related disease and suggest that mitochondrial dysfunction could contribute to this disorder. Myasthenia gravis patients with the rs2069762 variant, rs2069762 G/T and G/G genotype, and TAGG haplotype for IL-2 tended to respond poorly to Tac treatment.
  • ||||||||||  Firdapse (amifampridine) / BioMarin, Catalyst Pharmaceuticals
    Review, Journal:  Amifampridine tablets for the treatment of Lambert-Eaton myasthenic syndrome. (Pubmed Central) -  Nov 24, 2019   
    Hence, the drug represents a substantial step forward in the symptomatic treatment of the disease due to its efficacy, safety and reliable GMP formulation. As Amifampridine Phosphate works by enhancing the release of acetylcholine at the neuromuscular junction by blocking K+ efflux at the pre-synaptic membrane, it is also conceivable to use it for other diseases of the neuromuscular junction in which such an effect is searched for.
  • ||||||||||  Leustatin (cladribine) / J&J
    Clinical, Journal:  Cladribine shows promise in patients with difficult-to-treat myasthenia gravis. (Pubmed Central) -  Nov 24, 2019   
    As Amifampridine Phosphate works by enhancing the release of acetylcholine at the neuromuscular junction by blocking K+ efflux at the pre-synaptic membrane, it is also conceivable to use it for other diseases of the neuromuscular junction in which such an effect is searched for. No abstract available
  • ||||||||||  Orencia (abatacept) / BMS
    Enrollment change, Trial completion date, Trial termination, Trial primary completion date:  Trial of Orencia in Patients With Myasthenia Gravis (clinicaltrials.gov) -  Nov 22, 2019   
    P1,  N=6, Terminated, 
    She was diagnosed myasthenia gravis and symptoms resolved with MG treatments. N=20 --> 6 | Trial completion date: Apr 2020 --> Jul 2019 | Recruiting --> Terminated | Trial primary completion date: Apr 2020 --> Jul 2019; Mutual decision of sponsor and investigator due to logistical challenges
  • ||||||||||  Journal:  Myasthenic Crisis - Comorbidities, Complications, Long-Term Outcomes: The Challenges. (Pubmed Central) -  Nov 20, 2019   
    The main cornerstones of therapy will include (1) Identification of refractory MG with the implementation of phenotype-based therapy; (2) Addressing comorbidities including cardiac autonomic neuropathy, bulbar weakness, phrenic dysfunction; and (3) Meticulous tumor surveillance. No abstract available
  • ||||||||||  Journal:  Coexistence of Autoimmune Encephalitis and Other Systemic Autoimmune Diseases. (Pubmed Central) -  Nov 20, 2019   
    One or more types of ADs developed in AE patients, and patients with anti-LGI1 encephalitis had a higher frequency of autoimmune comorbidities than those with anti-NMDAR encephalitis. And we found that autoimmune comorbidities did not affect the clinical course of AE.
  • ||||||||||  Journal:  Comparison between thoracoscopic and open approaches in thymoma resection. (Pubmed Central) -  Nov 20, 2019   
    In summary, VATS is feasible for the treatment of thymoma complicated by MG. VATS can be performed in patients with Masaoka stage I, II and (a certain portion of) III thymoma; for some patients with Masaoka stage II thymoma, especially those with compression of the innominate vein, the use of VATS should be cautious.
  • ||||||||||  azathioprine orodispersible / Generic Mfg.
    Journal:  MuSK myasthenia gravis and pregnancy. (Pubmed Central) -  Nov 19, 2019   
    In group I, all were on steroids at time of conception, one on azathioprine and another receiving IVIG regularly...In this small series, pregnancy did not seem to precipitate MuSK-MG or to have a major influence in the MuSK-MG course, and there was no apparent negative impact in pregnancy outcomes in those where pregnancy followed the MG onset. The weight was lower in the newborn of the group I mothers, although none had low birth weight.
  • ||||||||||  Journal:  Superior Vena Cava Replacement for Thymic Malignancies. (Pubmed Central) -  Nov 14, 2019   
    En-bloc resection and conduit reconstruction of SVC is a good option to allow radical resection of locally advanced thymic tumours. Heterologous pericardial conduit represents the favourite option in our experience.
  • ||||||||||  Retrospective data, Review, Journal:  Thyroid disorders in patients with myasthenia gravis: A systematic review and meta-analysis. (Pubmed Central) -  Nov 13, 2019   
    Further research is needed to clarify these associations. This systemic review and meta-analysis provides reliable evidence that thyroid disorders are prevalent in MG, especially TGAb positivity, GD, hyperthyroidism, and HT, and MG is associated with increased risk for thyroid autoimmunity.
  • ||||||||||  Journal:  Nerve sparing surgery in advanced stage thymomas. (Pubmed Central) -  Nov 11, 2019   
    Phrenic nerve preservation in cases of invasive thymomas is feasible and may warrant an acceptable local control of disease, if associated with radiotherapy. According to these results, this technique could be proposed to all patients with invasive thymoma, especially in those affected by severe comorbidities or with a poor performance status.
  • ||||||||||  efgartigimod IV (ARGX-113 IV) / argenx, Broteio
    Review, Journal:  Next-generation Fc receptor-targeting biologics for autoimmune diseases. (Pubmed Central) -  Nov 10, 2019   
    Finally, Fc and FcγR-targeting therapeutics, comprise molecules that target the Fc of IgG, such as the recombinant soluble FcγIIb receptor valziflocept (SM101/SHP652) and various monoclonal antibodies directed against the receptors...Although initial results are promising, further long-term data and a better understanding of the unique mechanisms of action of the different molecules are needed. The efficacy, safety, convenience of administration, duration of effects, and cost will all contribute to determining which of the molecules will be successful in the clinic.
  • ||||||||||  NEUROMUSCULAR DISEASE MISTAKENLY DIAGNOSED AS ANGIOEDEMA (Monitor 3) -  Nov 9, 2019 - Abstract #ACAAI2019ACAAI_712;    
    Discussion This case exhibits a unique presentation of myasthenia gravis mistakenly identified as angioedema. It highlights the importance of a broad differential diagnosis for common allergic diseases.