Myasthenia Gravis
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  • ||||||||||  Bridion (sugammadex) / Merck (MSD)
    Risk of Administering Anesthesia in Undiagnosed Myasthenia Gravis (South: Hall F) -  Aug 23, 2023 - Abstract #ASA2023ASA_5792;    
    Stroke workup and electromyogram were negative. This case calls into question perioperative safety and preoperative screening in patients with symptoms consistent with undiagnosed neuromuscular junction disorders and how to reduce risk in hospitals where Sugammadex is not readily available.
  • ||||||||||  Bridion (sugammadex) / Merck (MSD)
    Perioperative Considerations for patients with Myasthenia Gravis (South: Hall F) -  Aug 23, 2023 - Abstract #ASA2023ASA_5769;    
    She was transferred to the ICU intubated where it was noted she did not receive her full dose of pre-operative pyridostigmine. She was treated for myasthenic crisis with pyridostigmine for 24 hours prior to extubation.
  • ||||||||||  Anesthetic Management of Patients with Myasthenia Gravis (Exhibit Hall) -  Aug 23, 2023 - Abstract #ASA2023ASA_4605;    
    Review of anesthetic techniques in a 78 year old with known myasthenia gravis undergoing neurosurgery for washout of an infected ventriculoperitoneal shunt. This case presents many different variables that can complicate anesthetic management such as maintenance of paralysis, avoiding precipitation of a myasthenic crisis, and mitigation of post operative mechanical ventilation.
  • ||||||||||  Anesthetic Considerations for a Parturient with Congenital Myasthenic Syndrome (Exhibit Hall) -  Aug 23, 2023 - Abstract #ASA2023ASA_4148;    
    The patient was extubated 8 hours later and did not experience residual effects. This case explores the nuances of preparing a safe anesthetic plan for a medically complex patient while simultaneously supporting a patient's right to autonomy.
  • ||||||||||  Anterior Cervical Disc Fusion In A Patient With Myasthenia Gravis (Exhibit Hall) -  Aug 23, 2023 - Abstract #ASA2023ASA_3853;    
    Preoperative evaluation examined the course of the disease, muscle groups involved, intensiveness of drug therapy, history of prior myasthenic crises, and coinciding diseases. Post operative respiratory muscle weakness can be a barrier to timely extubation.
  • ||||||||||  Review, Journal:  FcRN receptor antagonists in the management of myasthenia gravis. (Pubmed Central) -  Aug 21, 2023   
    Efgartigimod is already approved for the treatment of generalized MG, rozanolixizumab is under review by health authorities, and phase 3 trials of nipocalimab and batoclimab are underway. Here, we will review the available data on FcRn therapeutic agents in the management of MG.
  • ||||||||||  Review, Journal:  NMJ-related diseases beyond the congenital myasthenic syndromes. (Pubmed Central) -  Aug 21, 2023   
    We also underscore the fact that NMJs may differ between species, muscles or even sexes. Hence the importance of choosing a good model organism for the study of NMJ-related diseases: only taking into account the specific features of the mammalian NMJ, experimental results would be efficiently translated to the clinic.
  • ||||||||||  Comirnaty (tozinameran) / Pfizer, Fosun Pharma, BioNTech, Spikevax (elasomeran) / Moderna
    Journal:  COVID-19 vaccination-related autoimmune hepatitis-a perspective. (Pubmed Central) -  Aug 21, 2023   
    The co-existence of myasthenia gravis and autoimmune hepatitis is rare, and a cohort of patients with myasthenia gravis anti-titin antibodies seems to be highly relevant. In consideration of these data and the number of patients who may not be symptomatic, we postulated that autoimmune phenomena may not be exceedingly rare, following the administration of mRNA technology-based vaccines, and a balance between pros and cons in administrating boosters is critical.
  • ||||||||||  Observational data, Journal, Real-world evidence, Real-world:  A decentralized, prospective, observational study to collect real-world data from patients with myasthenia gravis using smartphones. (Pubmed Central) -  Aug 17, 2023   
    P=N/A
    Finally, application of unsupervised machine learning methods identified unique clusters of exacerbation subtypes, each with their own specific representation of symptoms and symptom severity. While these symptom signatures require further study and validation, our results suggest that digital phenotyping, characterized by increased multidimensionality and frequency of the data collection, holds promise for furthering our understanding of clinically significant exacerbations and reimagining the approach to treating MG as a heterogeneous condition.
  • ||||||||||  Review, Journal:  Autoimmune myasthenia gravis and COVID-19. A case report-based review. (Pubmed Central) -  Aug 15, 2023   
    All patients improved following treatment. Proof of direct causality between the two conditions can only be established in time by confirming epidemiological increase in the incidence of MG or elucidating pathogenic mechanisms to substantiate a possible cause-effect association, or both.
  • ||||||||||  Rituxan (rituximab) / Biogen, Zenyaku Kogyo, Roche
    Review, Journal:  Immunotherapies in MuSK-positive Myasthenia Gravis; an IgG4 antibody-mediated disease. (Pubmed Central) -  Aug 15, 2023   
    Exceptional clinical response to plasmapheresis and rituximab has been particularly observed in these patients...New precision medicine approaches involve Chimeric autoantibody receptor T (CAAR-T) cells that are engineered to target antigen-specific B cells in MuSK-MG and represent a milestone in the development of targeted immunotherapies. This review aims to provide a detailed update on the pathomechanisms involved in MuSK-MG (cellular and humoral aberrations), fostering the understanding of the latest indications regarding the efficacy of different treatment strategies.
  • ||||||||||  vemircopan (ALXN2050) / AstraZeneca
    Trial completion date, Trial primary completion date:  ALXN2050-MG-201: Study of ALXN2050 in Adult Participants With Generalized Myasthenia Gravis (clinicaltrials.gov) -  Aug 15, 2023   
    P2,  N=70, Recruiting, 
    This review aims to provide a detailed update on the pathomechanisms involved in MuSK-MG (cellular and humoral aberrations), fostering the understanding of the latest indications regarding the efficacy of different treatment strategies. Trial completion date: Sep 2025 --> Dec 2025 | Trial primary completion date: Jun 2023 --> Nov 2023
  • ||||||||||  Clinical, Review, Journal:  On the path to evidence-based therapy in neuromuscular disorders. (Pubmed Central) -  Aug 15, 2023   
    As in all scientific endeavors, the successful clinical translation depends on the quality and translatability of preclinical findings and on the predictive value and feasibility of the clinical models. This chapter focuses on five exemplary diseases: childhood spinal muscular atrophy (SMA), Charcot-Marie-Tooth (CMT) disorders, chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), acquired autoimmune myasthenia gravis (MG), and Duchenne muscular dystrophy (DMD), to illustrate the progress made on the path to evidenced-based therapy.
  • ||||||||||  Keytruda (pembrolizumab) / Merck (MSD)
    Pembrolizumab Associated Myocarditis, Myasthenia Gravis, and Myositis (Zone 4, Science and Technology Hall, Level 2) -  Aug 12, 2023 - Abstract #AHA2023AHA_5473;    
    The mainstay treatments of ICI-induced myocarditis include holding the offending immune-checkpoint inhibitor, high-dose corticosteroids, and guideline-directed medical therapy for associated heart failure or arrhythmias. Abatacept, a cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) immunoglobulin fusion protein, and ruxolitinib, a JAK 1/2 inhibitor, have recently been suggested as a novel combination to reduce mortality from ICI-associated myocarditis with concomitant myositis.
  • ||||||||||  Journal:  New and emerging treatments for myasthenia gravis. (Pubmed Central) -  Aug 10, 2023   
    Finally, we performed a complete review of the literature, which confirmed that ICI treatment could be discussed for patients with paraneoplastic LEMS, and emphasized the need for multidisciplinary management. No abstract available
  • ||||||||||  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 (M1+2) -  Aug 8, 2023 - Abstract #EADV2023EADV_1942;    
    Most TEAEs, including infections, were mild or moderate in severity and did not increase in frequency with recurrent dosing. FcRn inhibition by efgartigimod is a promising therapeutic option for autoimmune diseases mediated by pathogenic IgG autoantibodies.
  • ||||||||||  azathioprine / Generic mfg.
    Retrospective data, Journal:  Clinical features and outcomes of patients with myasthenia gravis admitted to an intensive care unit: A 20-year retrospective study. (Pubmed Central) -  Aug 7, 2023   
    The treatments received for MG included pyridostigmine (73.5%), corticosteroids (55.9%), azathioprine (35.3%), plasmapheresis (26.5%) and intravenous immunoglobulin (8.8%)...It is, however, a potentially manageable disease, provided that appropriate ICU resources are available. This study provides further insight into the characteristics and outcomes of myasthenia gravis patients in ICU, within a South African context.
  • ||||||||||  Poteligeo (mogamulizumab) / Kyowa Kirin
    Journal:  Mogamulizumab-Associated Myositis With and Without Myasthenia Gravis and/or Myocarditis in Patients With T-Cell Lymphoma. (Pubmed Central) -  Aug 7, 2023   
    The incidence (n = 5/42, 11.9%) of muscular mogamulizumab-associated irAEs may be higher than has been previously reported in clinical trials and may be of late onset (a median of 5 cycles and as late as 100 days from the last infusion). We highlight the utility of IVIG, together with systemic corticosteroids, for the treatment of these potentially fatal side effects associated with mogamulizumab therapy.