Myasthenia Gravis
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  • ||||||||||  Journal:  A man with hanging eyelids (Pubmed Central) -  Oct 12, 2023   
    Myasthenia gravis preached on top of the differential diagnosis. Subsequent blood tests showed antibodies against ACh-receptors and confirmed the diagnosis.
  • ||||||||||  Journal:  Altered gut microbiota and metabolites in untreated myasthenia gravis patients. (Pubmed Central) -  Oct 4, 2023   
    Our findings suggest that dysbiosis already exists in newly diagnosed and untreated MG patients, implying that dysbiosis within the gut microbiota may be an initiating factor contributing to MG pathogenesis. Furthermore, F. prausnitzii may hold promise as a probiotic for treating MG.
  • ||||||||||  New trial:  VRMG: Vitaccess Real MG Registry (clinicaltrials.gov) -  Oct 3, 2023   
    P=N/A,  N=600, Not yet recruiting, 
  • ||||||||||  The Value of Postoperative Radiotherapy in Thymoma with Myasthenia Gravis (Hall B2; In Person Only; Screen: 34) -  Oct 2, 2023 - Abstract #ASTRO2023ASTRO_2493;    
    Patients in the higher histologic subtype and Masaoka-Koga staging may benefit more obviously. Abstract 2180 - Table 1 DFS OS MMS Variables HR 95%CI p HR 95%CI p HR 95%CI p Gender (male vs.
  • ||||||||||  Journal:  Can Scoliosis Help the Early Diagnosis of Congenital Myasthenic Syndrome? (Pubmed Central) -  Sep 28, 2023   
    Both the patient with CHAT mutation and RAPSN mutation had arthrogryposis. Conclusion In this study, CMS stands out as an essential consideration in the differential diagnosis, particularly when scoliosis accompanies early-onset muscle weakness.
  • ||||||||||  Review, Journal:  Diagnosis and Management of Seronegative Myasthenia Gravis: Lights and Shadows. (Pubmed Central) -  Sep 28, 2023   
    The early identification of these patients is needed in order to ensure early treatment and prevent complications. This narrative review aims to examine the latest updates on SnMG, defining the clinical characteristics of affected patients, diagnostic methods, management, and therapeutic scenarios.
  • ||||||||||  Vyvgart Hytrulo (efgartigimod alfa and hyaluronidase-qvfc) / argenx, Vyvgart (efgartigimod alfa-fcab) / argenx, Broteio
    Efgartigimod: A Novel FcRn Antagonist in the Treatment of Autoimmune Diseases (e-Poster Hall) -  Sep 27, 2023 - Abstract #EADV2023EADV_4639;    
    This narrative review aims to examine the latest updates on SnMG, defining the clinical characteristics of affected patients, diagnostic methods, management, and therapeutic scenarios. FcRn inhibition by efgartigimod is a promising therapeutic option for autoimmune diseases mediated by pathogenic IgG autoantibodies.
  • ||||||||||  Retrospective data, Review, Journal:  Altered Cardiac Autonomic Regulation in Individuals with Myasthenia Gravis-A Systematic Review and Meta-Analysis. (Pubmed Central) -  Sep 27, 2023   
    MG patients vs. HCs had higher systolic blood pressure (g = 0.39; I = 56.1), sympathovagal balance at rest/during tilt (LF/HF-RRI, g = 0.44; I = 0; LF/HF-RRI, g = 0.86; I = 0; LF/HF, g = 0.40; I = 0). As a group, MG patients have altered cardiac autonomic function, including decreased parasympathetic function, lower baroreflex sensitivity, and higher sympathovagal balance at rest and during orthostatic challenges.
  • ||||||||||  Myositis Triad Subset Is Associated with High Mortality in Immune Checkpoint Inhibitor- Induced Myositis (Room 25A-C; in person) -  Sep 23, 2023 - Abstract #ACRConvergence2023ACR_Convergence_2015;    
    A signal for potential association with ICI triad subset was seen with genitourinary cancers that will require further investigation. A strong trend for increased early mortality in the ICI triad subset closely following ICI initiation was observed in comparison to patients with myositis alone and ICI-treated veterans without myositis.
  • ||||||||||  Opdivo (nivolumab) / Ono Pharma, BMS, Yervoy (ipilimumab) / Ono Pharma, BMS
    Immune Checkpoint Inhibitor-Related Myocarditis and Overlapping Syndromes (Zone 4, Science and Technology Hall, Level 2) -  Sep 21, 2023 - Abstract #AHA2023AHA_7733;    
    While our patient had laboratory and biomarker improvement of his myocarditis, hepatitis, and myositis, he developed progressive weakness and respiratory failure. Our case highlights the complexity and challenges of managing ICI-related myocarditis and overlapping syndromes, including MG, and its poor prognosis despite prompt treatment.
  • ||||||||||  relatlimab (BMS-986016) / BMS, Ono Pharma, Opdivo (nivolumab) / Ono Pharma, BMS
    Case of Severe Myocarditis Associated With Nivolumab-Relatlimab (Zone 4, Science and Technology Hall, Level 2) -  Sep 21, 2023 - Abstract #AHA2023AHA_7732;    
    This is one of the few reported cases of severe myocarditis from Nivolumab/Relatlimab. As the combination is still in phase IV development, more cases may emerge in the future and early recognition is vital.
  • ||||||||||  Enrollment change:  Study of Myasthenic Crisis in China (clinicaltrials.gov) -  Sep 21, 2023   
    P=N/A,  N=300, Recruiting, 
    As the combination is still in phase IV development, more cases may emerge in the future and early recognition is vital. N=100 --> 300
  • ||||||||||  Rystiggo (rozanolixizumab) / UCB
    Review, Journal:  Rozanolixizumab: First Approval. (Pubmed Central) -  Sep 21, 2023   
    Clinical development is ongoing for the treatment of leucine-rich glioma-inactivated 1 autoimmune encephalitis, myelin oligodendrocyte glycoprotein (MOG) antibody disease and severe fibromyalgia syndrome. This article summarizes the milestones in the development of rozanolixizumab leading to this first approval for the treatment of gMG in adults who are anti-AChR or anti-MuSK antibody positive.
  • ||||||||||  prednisone / Generic mfg.
    Journal:  Long-term efficacy and safety of tacrolimus in young children with myasthenia gravis. (Pubmed Central) -  Sep 20, 2023   
    To clarify the prognostic relevance and clinical usefulness of the WHO classification may be beneficial in clinical practice for the treatment decision. A course of tacrolimus of more than one year was effective and well-tolerated in young children with MG, and tacrolimus improved MG symptoms and reduced the dose and adverse events of oral prednisone.
  • ||||||||||  Journal:  Suspected Fluoroquinolone-Induced Exacerbation of Myasthenia Gravis in Dogs. (Pubmed Central) -  Sep 18, 2023   
    Marked improvement in generalized weakness was reported 36 hr after discontinuation of fluoroquinolone therapy alone in one dog and in combination with pyridostigmine in two dogs. Fluoroquinolone therapy was never stopped in three dogs who were euthanized because of severe weakness and one dog who died of respiratory arrest.
  • ||||||||||  methotrexate / Generic mfg.
    Clinical, Review, Journal:  Methotrexate in generalized myasthenia gravis: a systematic review. (Pubmed Central) -  Sep 18, 2023   
    Adverse effects were rare with non-specific pain and elevated transaminases as the most common complaints. Based on available evidence, MTX may be a safe and effective alternative to AZA as steroid sparing agent in developing countries.
  • ||||||||||  prednisone / Generic mfg., azathioprine / Generic mfg.
    Journal:  Prognostic predictors of remission in ocular myasthenia gravis. (Pubmed Central) -  Sep 18, 2023   
    Based on available evidence, MTX may be a safe and effective alternative to AZA as steroid sparing agent in developing countries. The presence of AchR Abs (p?=?0.034) and an abnormal SFEMG (p?=?0.006) at onset as increased risk factors for the presence of ongoing signs necessitating medical treatment.
  • ||||||||||  Review, Journal:  COVID-19: a modern trigger for Guillain-Barre syndrome, myasthenia gravis, and small fiber neuropathy. (Pubmed Central) -  Sep 15, 2023   
    The peripheral nervous system, lacking the protection afforded by the blood-brain barrier, has been a particular site of sequelae and complications subsequent to COVID-19 infection, including Guillain-Barre syndrome, myasthenia gravis, and small fiber neuropathy. We will discuss these disorders in terms of their clinical manifestations, diagnosis, and treatment as well as the pathophysiology in relation to COVID-19.
  • ||||||||||  Rituxan (rituximab) / Biogen, Zenyaku Holdings, Roche
    A Rare Case Of IgG4-Related Disease In An Adult Female Presenting As Diplopia (Monitor 05) -  Sep 14, 2023 - Abstract #ACAAI2023ACAAI_824;    
    Rituximab infusion was prescribed every two weeks initially for two doses then every six months...Discussion Since IgG4-related disease is difficult to diagnose, the approach must be systematic and multi-disciplinary. Appropriate diagnostic tests should be done to rule out diseases that can masquerade it.
  • ||||||||||  epinephrine / Generic mfg.
    Desensitization to IVIG in a Patient with a Complex Allergy History (Monitor 03) -  Sep 14, 2023 - Abstract #ACAAI2023ACAAI_585;    
    Epinephrine, methylprednisolone, and albuterol were given with resolution of her symptoms...More recently, the patient has been able to tolerate a treatment of 40 grams in a single day. Discussion Desensitization to IVIG is uncommon and may need to be tailored to a specific patient's clinical needs.