Myasthenia Gravis
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  • ||||||||||  Rituxan (rituximab) / Biogen, Zenyaku Kogyo, Roche
    Clinical, Journal:  Rituximab for the treatment of generalised myasthenia gravis: experience in clinical practice (Pubmed Central) -  Mar 11, 2022   
    Tacrolimus can be used alone for the initial immunotherapy of MG patients, especially for young, mild, and low antibody titer patients. In our experience, rituximab is a safe and effective treatment in aggressive generalised MG with anti-MuSK or late-onset MG (LOMG).
  • ||||||||||  NN1213 / Novo Nordisk
    Enrollment open, Trial completion date, Trial primary completion date:  QUESST: Innovative Measures of Speech and Swallowing Dysfunction in Neurological Disorders (clinicaltrials.gov) -  Mar 11, 2022   
    P=N/A,  N=200, Recruiting, 
    This study supports the usefulness of the VOG device in revealing subclinical extraocular muscle involvement in MG. Suspended --> Recruiting | Trial completion date: Jan 2022 --> Dec 2026 | Trial primary completion date: Dec 2021 --> Dec 2025
  • ||||||||||  cyclosporine / Generic mfg.
    Clinical, Journal:  Open thoracoabdominal aortic aneurysm repair in a patient with myasthenia gravis. (Pubmed Central) -  Mar 8, 2022   
    Preoperatively, MG was well-controlled by prednisolone, cyclosporin and pyridostigmine...The patient was weaned from mechanical ventilatory support on postoperative day 7. No signs of spinal cord ischaemia or muscle weakness were seen.
  • ||||||||||  methotrexate / Generic mfg., cyclosporine / Generic mfg.
    Journal:  Myasthenia gravis-treatment and severity in nationwide cohort. (Pubmed Central) -  Mar 8, 2022   
    No signs of spinal cord ischaemia or muscle weakness were seen. Our findings confirm significant healthcare burden of MG, comprising a tool to plan resources needed for MG patients.
  • ||||||||||  Soliris (eculizumab) / AstraZeneca, Vyvgart (efgartigimod alfa-fcab) / argenx, Broteio
    Numbers Needed to Treat and Costs per Improved Outcome Among Treatments for Myasthenia Gravis (In-person & Virtual) -  Mar 8, 2022 - Abstract #ISPOR2022ISPOR_560;    
    P2, P3
    NNT and cost per improved efficacy help inform comparative clinical efficacy and cost-effectiveness across MG treatments. Evidence indicates more favorable treatment benefit and economic value for EFG with fewer NNT and lower cost required to achieve improved outcomes compared to other treatments.
  • ||||||||||  Journal:  Essen transition model for neuromuscular diseases (Pubmed Central) -  Mar 8, 2022   
    Extended thymectomy should be performed on all patients with thymoma, whether they have MG or not. The Essen transition model aims to close a gap in the transition of patients with neuromuscular diseases and improve healthcare in these patients with their complex needs.
  • ||||||||||  Sex Differences in Inpatient Outcomes following Hospitalization for Myasthenic Crisis (Poster Hall) -  Mar 6, 2022 - Abstract #AAN2022AAN_3952;    
    Male patients experience significantly worse outcomes, in terms of complication rates, following hospitalization for myasthenic crisis. These findings underscore the importance of not only using gender as a risk-prediction tool, but also tailoring inpatient care pathways and health resources utilization to provide equitable care.
  • ||||||||||  prednisone / Generic mfg.
    Immune Mediated Bulbar Myasthenia Gravis Incited by SARS-CoV2 mRNA Vaccination. (Poster Hall) -  Mar 6, 2022 - Abstract #AAN2022AAN_3658;    
    Further, the patient’s bifacial weakness with impaired eyelid closure was atypical in contrast to ptosis and diploia typically observed in oculo-bulbar forms of myasthenia gravis. The immune-mediated mechanism and clinical phenotype of SARS-CoV2 vaccination-associated myasthenia gravis require further investigation.
  • ||||||||||  Rituxan (rituximab) / Biogen, Zenyaku Kogyo, Roche
    Overlapping Autoimmune Neurologic Syndrome, A case report of triple-positive antibody (Poster Hall) -  Mar 6, 2022 - Abstract #AAN2022AAN_3368;    
    Therefore, clinicians need to be vigilant about the overlap neurological syndromes affecting central and peripheral nervous systems to avoid delays in the diagnosis and treatment to prevent poor clinical outcomes. It is equally important to address poor response to the first-line immunosuppressive therapy as the continuation of these therapies may not be effective in some cases.
  • ||||||||||  Orencia (abatacept) / BMS, Opdivo (nivolumab) / Ono Pharma, BMS
    A Case of Myasthenia Gravis and Myositis after Immunotherapy and COVID Vaccine (Poster Hall) -  Mar 6, 2022 - Abstract #AAN2022AAN_3350;    
    Our patient presented 1 week after first treatment, perhaps influenced by COVID vaccine. Management of nIRAE is consensus-based, as no standard evidence-based treatment exists.
  • ||||||||||  Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
    New Diagnosis of Myasthenia Gravis in the Setting of COVID-19 Infection (Poster Hall) -  Mar 6, 2022 - Abstract #AAN2022AAN_3104;    
    This case raises the possibility of myasthenia and/or myasthenic crisis being a neurological complication of COVID-19 infection. Mechanisms behind this have been postulated to include molecular mimicry, the inflammatory cascade of COVID-19 leading to immune dysregulation, or viral illness triggering previously asymptomatic patients.
  • ||||||||||  Comirnaty (tozinameran) / Pfizer, Fosun Pharma, BioNTech
    Myasthenia Gravis Syndrome Following COVID-19 Vaccination and Subsequent Tolerance of Booster Vaccine: A Case Report (Poster Hall) -  Mar 6, 2022 - Abstract #AAN2022AAN_3103;    
    Rare COVID-19 vaccine-associated neuro-immunological cases have been observed and this case highlights the need for continued vaccine monitoring, as well as the potential to tolerate booster vaccination if the underlying neuro-immunologic condition is controlled. In addition to this case presentation and review of the relevant literature, we also present our analysis of the ongoing Vaccine AE Reporting System as it pertains to MG.
  • ||||||||||  Keytruda (pembrolizumab) / Merck (MSD)
    Pembrolizumab Associated Myasthenia Gravis and Myocarditis Associated with Anti-striational Antibody (Poster Hall) -  Mar 6, 2022 - Abstract #AAN2022AAN_2952;    
    Background: We report a case with successful outcome of pembrolizumab associated anti-striational antibody myasthenia gravis (MG) after being treated aggressively with methylprednisolone, Intravenous immunoglobulin (IVIG) and plasmapheresis (PLEX). Early aggressive treatment with IVIG or PLEX and steroids, regardless of initial symptoms severity, may lead to better outcomes in patients presenting with pembrolizumab associated anti-striational antibody MG.
  • ||||||||||  apraclonidine / Generic mfg.
    Efficacy of Apraclonidine in Treating Ptosis Secondary to Myasthenia Gravis (Poster Hall) -  Mar 6, 2022 - Abstract #AAN2022AAN_2947;    
    Polypharmacy that included high-dose corticosteroids was associated with a greater incidence of new endocrine and neuropsychiatric comorbid events within 1 year of diagnosis. Apraclonidine may be an effective and safe alternative treatment for patients with ptosis secondary to MG.
  • ||||||||||  Treatment Burden According to Patients with Generalized Myasthenia Gravis (Poster Hall) -  Mar 6, 2022 - Abstract #AAN2022AAN_2943;    
    Although many patients believe their current treatment regimen is effective, there is room for improvement in disease control, treatment toxicity, and amount of time to arrive at an effective treatment. There is preference for targeted gMG therapy with low side effect profile.