Myasthenia Gravis
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  • ||||||||||  Journal:  Congenital myasthenic syndrome from a MUSK gene mutation. (Pubmed Central) -  Nov 21, 2023   
    After a novel neuromuscular gene panel became available, we identified a mutation in the MUSK gene (muscle-specific kinase), confirming a diagnosis of congenital myasthenic syndrome. This group of rare disorders are caused by mutations in genes encoding the neuromuscular junction.
  • ||||||||||  Review, Journal:  Pediatric Neuromuscular Diseases. (Pubmed Central) -  Nov 21, 2023   
    Families are also increasingly interested in clinical research, which may include natural history studies and interventional clinical trials. Such research has proliferated for rare neuromuscular diseases, leading to exciting advances in diagnostic and therapeutic technologies, promising dramatic changes in the landscape of these disorders in the years to come.
  • ||||||||||  Bridion (sugammadex) / Merck (MSD)
    Journal:  Undiagnosed Lambert-Eaton Myasthenic Syndrome in the Era of Sugammadex: A Case Report. (Pubmed Central) -  Nov 18, 2023   
    However, proper monitoring of the depth and recovery of blockade is imperative to when using sugammadex with optimal safety and precision in all patients. Perioperative care teams must remain vigilant with a high index of suspicion for neuromuscular junction pathology to properly plan perioperative care for patients at risk, especially those with small cell lung cancer who may have undiagnosed LEMS.
  • ||||||||||  Journal:  What Is in the Neuromuscular Junction Literature? (Pubmed Central) -  Nov 18, 2023   
    The notion of using fast-acting therapies early in the course of MG is addressed. The last sections center on MG and Lambert-Eaton myasthenic syndrome as a consequence of immune checkpoint inhibitor therapy.
  • ||||||||||  Imfinzi (durvalumab) / AstraZeneca, Opdivo (nivolumab) / Ono Pharma, BMS
    Journal, Checkpoint inhibition:  Plasma Exchange in Patients With Myositis due to Immune Checkpoint Inhibitor Therapy. (Pubmed Central) -  Nov 18, 2023   
    Another 77-year-old man with Stage IIIB squamous cell carcinoma of the lung developed progressive proximal muscle weakness and became nonambulatory after cycle 2 of durvalumab with persistently high creatine kinase levels despite prednisone treatment...With PLEX, both patients noticed rapid improvement in strength. PLEX in conjunction with other immunosuppressive agents can result in rapid improvement in irAE-myositis even in patients without associated MG.
  • ||||||||||  Journal:  Pregnancy in Seronegative Myasthenia Gravis: A Single-Center Case Series. (Pubmed Central) -  Nov 18, 2023   
    PLEX in conjunction with other immunosuppressive agents can result in rapid improvement in irAE-myositis even in patients without associated MG. As in seropositive MG, increased MG symptoms during pregnancy and within 6 months postpartum is also seen in women with DSNMG.
  • ||||||||||  Myasthenia Gravis Induced by Concussion: A Case Report () -  Nov 16, 2023 - Abstract #AAPMR2023AAPMR_827;    
    This case demonstrates the ability for concussion and other trauma to induce autoimmune processes. These diseases should be considered during evaluation.
  • ||||||||||  Opdivo (nivolumab) / Ono Pharma, BMS
    A Rare Case of Immunotherapy Induced Myasthenia Gravis, Myocarditis, and Myositis () -  Nov 16, 2023 - Abstract #AAPMR2023AAPMR_713;    
    Case Diagnosis: 75 year old male with lung adenocarcinoma treated with immune checkpoint inhibitor (ICI) nivolumab and developed myasthenia gravis (MG), myocarditis, and myositis.Case Description or Program Description: Patient noted diplopia four days post-treatment with carboplatin, paclitaxel, and nivolumab...Patient received plasma exchange, intravenous immune globulin, and pyridostigmine for MG and solumedrol for myocarditis... Knowledge of this fatal complication of ICIs, such as nivolumab, can assist physiatrists in caring for and initiating rehabilitation of cancer patients in the ARU.
  • ||||||||||  riluzole / Generic mfg.
    Unusual Presentation of Amyotrophic Lateral Sclerosis in a Patient with Recurrent Prostate Cancer: A Case Report () -  Nov 16, 2023 - Abstract #AAPMR2023AAPMR_559;    
    Cancer rehabilitation physicians play a critical role in early recognition and timely diagnosis of disorders like paraneoplastic syndromes and neurodegenerative diseases that can be severely debilitating, difficult to diagnose, and challenging to treat. Patients with a cancer history and concurrent ALS require unique rehabilitation considerations.
  • ||||||||||  Keytruda (pembrolizumab) / Merck (MSD), Opdivo (nivolumab) / Ono Pharma, BMS
    Functional Recovery Following Immunotherapy-induced Myasthenia Gravis: A Case Report () -  Nov 16, 2023 - Abstract #AAPMR2023AAPMR_512;    
    Patients with immunotherapy-induced MG have potential to make significant functional gains and may be appropriate to consider for acute inpatient rehabilitation admission. As indications for immune checkpoint inhibitors expand, it is important for physiatrists to recognize and be able to manage side effects of this therapy.
  • ||||||||||  Thymoglobulin (anti-thymocyte globulin (rabbit)) / Sanofi
    Journal:  Remission of severe myasthenia gravis after autologous stem cell transplantation. (Pubmed Central) -  Nov 16, 2023   
    This response may suggest that a cell-mediated etiology may be a significant contributing factor in refractory MG cases. A phase 2 clinical trial is warranted to establish if HDIT/HCT can be an effective therapy for severe refractory MG and to gain a further understanding of disease pathogenesis.
  • ||||||||||  Journal:  Unexpected fibrous mediastinitis in a patient with myasthenia gravis - a case report. (Pubmed Central) -  Nov 14, 2023   
    A phase 2 clinical trial is warranted to establish if HDIT/HCT can be an effective therapy for severe refractory MG and to gain a further understanding of disease pathogenesis. This rare case might enrich our knowledge of the relationship between FM and autoimmune diseases.
  • ||||||||||  Bekemv (eculizumab biosimilar) / Amgen
    Journal:  Functional similarity of ABP 959 and eculizumab in simulated serum models of aHUS and NMOSD. (Pubmed Central) -  Nov 13, 2023   
    This work presents a full comparison of the effect of C5 inhibition across five complement functional assays. Using this approach to confirm functional similarity of ABP 959 with eculizumab RP contributes to the TOE for biosimilarity and provides support for extrapolation based on inhibition of C5 function to other rare disease indications approved for eculizumab RP.
  • ||||||||||  Comirnaty (tozinameran) / Pfizer, Fosun Pharma, BioNTech
    Journal:  Humoral immune response to COVID-19 vaccine in patients with myasthenia gravis. (Pubmed Central) -  Nov 13, 2023   
    The SARS-CoV-2 IgG response and neutralizing capacity were measured in 83 patients (57 on immunosuppressants) and 332 healthy controls at baseline, three weeks, and two and six months after the vaccine. We found that the proportion of positive humoral response was lower in patients on immunosuppressants vs. controls at three weeks and two months (p
  • ||||||||||  Journal:  Personality factors in patients with myasthenia gravis: A prospective study. (Pubmed Central) -  Nov 13, 2023   
    The data indicate that muscle weakness in MG is accompanied or even complicated by psychological aspects. Therefore, a psychological and behavioral intervention in addition to the specific pharmacological therapy might be of particular value.
  • ||||||||||  Journal:  COVID-19 vaccination and myasthenia gravis. (Pubmed Central) -  Nov 10, 2023   
    https://classic.clinicaltrials.gov/ct2/show/NCT05649761?term=QL1604&draw=2&rank=1, identifier NCT05649761. No abstract available
  • ||||||||||  fentanyl citrate / Generic mfg.
    Retrospective data, Journal:  Radiologically inserted gastrostomy tube in neurological disease: A retrospective study. (Pubmed Central) -  Nov 9, 2023   
    The balloon group received significantly lower preoperative sedation in the form of fentanyl (Avg = 4.46 min vs. 6.54 min, P = 0.287)...BMI, age, and gender did not significantly affect minor complication rates. RIG tube insertions may serve as a valuable, alternative approach in providing enteral support in patients with neurological disease.
  • ||||||||||  Enrollment open, Phase classification:  Yogic Breathing Exercise for People With Amyotrophic Lateral Sclerosis (clinicaltrials.gov) -  Nov 9, 2023   
    P=N/A,  N=30, Recruiting, 
    This retrospective study demonstrates MG in the elderly presents with a significant iatrogenic risk, including fatal immunosuppressant-related infections. Not yet recruiting --> Recruiting | Phase classification: P2 --> PN/A