- |||||||||| Retrospective data, Journal: Robotic surgery vs. open surgery for thymectomy, a retrospective case-match study. (Pubmed Central) - Oct 13, 2021
The robotic-assisted technique showed the same operative time and complications rate compared with open surgery, thereby confirming its safety and feasibility in myasthenic patients as well as in Masaoka I-II thymomas. The lower postoperative pain and the shorter hospital stay associated with prompt mobilisation and faster chest drainage removal showed the great advantage of the minimally invasive robotic approach in these patients.
- |||||||||| Clinical, Journal: Cholinergic hyperactivity in patients with myasthenia gravis with MuSK antibodies: A neurophysiological study. (Pubmed Central) - Oct 13, 2021
Our findings show that a strategy focused on obtaining orphan drug designation, expanding therapeutic indications and the geographic range of marketing approvals, extending monopoly periods, and prioritizing public procurement niches has enhanced revenues and helped the company achieve leadership in a highly specific and profitable market. R-CMAP detection can represent a useful diagnostic clue for MuSK-MG and predicts poor tolerance to AChE-Is.
- |||||||||| pyridostigmine Bromide / Generic mfg., azathioprine / Generic mfg.
Clinical, Journal: Primary biliary cirrhosis associated with myasthenia gravis after postpartum: a case report. (Pubmed Central) - Oct 12, 2021 Given the fluctuation of the immune status during the postpartum period, combined autoimmune diseases need to be taken into account when patients develop clinical symptoms of an autoimmune disease. Therefore, detailed physical and laboratory examination can help to prevent the missed diagnosis of these diseases.
- |||||||||| Clinical, Review, Journal: SARS-CoV-2 (COVID-19) in Patients with some Degree of Immunosuppression (Pubmed Central) - Oct 12, 2021
In transplant patients (renal, cardiac and hepatic), with neurological pathologies (multiple sclerosis [MS], neuromyelitis optica [NMODS], myasthenia gravis [MG]), primary immunodeficiencies and infection with human immunodeficiency virus (HIV) in association with immunosuppressants, studies have shown no tendency for worse outcomes. Given the little evidence we have so far, the behaviour of SARS-CoV-2 infection in immunosuppressed patients is unclear, but current studies have not shown worse outcomes, except for patients with cancer.
- |||||||||| Zilbrysq (zilucoplan) / UCB
Trial completion date, Trial primary completion date: RAISE: Safety, Tolerability, and Efficacy of Zilucoplan in Subjects With Generalized Myasthenia Gravis (clinicaltrials.gov) - Oct 12, 2021 P3, N=174, Active, not recruiting, Given the little evidence we have so far, the behaviour of SARS-CoV-2 infection in immunosuppressed patients is unclear, but current studies have not shown worse outcomes, except for patients with cancer. Trial completion date: Nov 2021 --> Feb 2022 | Trial primary completion date: Sep 2021 --> Dec 2021
- |||||||||| Clinical, Journal: Maximizing placebo response in neurological clinical practice. (Pubmed Central) - Oct 9, 2021
Future studies regarding more specific neurobiological mechanisms will allow a finer tuning of placebo response in clinical practice. The use of placebo in clinical practice raises ethical issues, and a recent expert consensus regarding placebo use in the clinic is a first step to future guidelines necessary to this field.
- |||||||||| Clinical, Journal: Coexistence of Systemic Lupus Erythematosus and Myasthenia Gravis: An Unusual Case of Polyautoimmunity. (Pubmed Central) - Oct 8, 2021
The coexistence of myasthenia gravis (MG) and systemic lupus erythematosus (SLE) is a clinical challenge due to the possible differential diagnoses of muscle involvement in patients with SLE. We present the case of a patient who came to the emergency room of Hospital Universitario San Ignacio in Bogotá, Colombia, with a previous diagnosis of SLE, who developed acute weakness in the context of a systemic infection, with a clinical and electrophysiological diagnosis of MG.
- |||||||||| Clinical, Journal: Analysis of the application of glucocorticoids in eight pediatric neurological disorders in China (Pubmed Central) - Oct 7, 2021
The multivariate Logistic regression analysis indicated that the use of glucocorticoids was more standardized in bacterial meningitis (OR=1.83, 95%CI 1.39-2.43, P<0.01), Guillain-Barre syndrome (OR=1.97, 95%CI 1.50-2.59, P<0.01), Duchenne muscular dystrophy (OR=1.85, 95%CI 1.38-2.48, P<0.01), juvenile dermatomyositis (OR=2.08, 95%CI 1.03-4.19, P=0.040) and N-methyl-D-aspartate receptor encephalitis (OR=0.302, 95%CI 0.20-0.46, P<0.01) and by pediatricians with pediatric neurology specialty in the hospital. The coincidence rate with recommendation of the current guideline or consensus on glucocorticoids is less than half in children with neurological diseases, and the use of glucocorticoids is more standardized in a variety of diseases by pediatricians with pediatric neurology specialty in the hospital, which indicates that the study of guidelines or consensus and the special training of pediatric neurologists should be further strengthened.
- |||||||||| Clinical, Journal: Comment on case series of COVID-19 in patients with myasthenia gravis: a single institution experience by Županić et al. (Pubmed Central) - Oct 6, 2021
The coincidence rate with recommendation of the current guideline or consensus on glucocorticoids is less than half in children with neurological diseases, and the use of glucocorticoids is more standardized in a variety of diseases by pediatricians with pediatric neurology specialty in the hospital, which indicates that the study of guidelines or consensus and the special training of pediatric neurologists should be further strengthened. No abstract available
- |||||||||| Journal: Evaluation of outcome measures for myasthenia gravis subgroups. (Pubmed Central) - Oct 6, 2021
Patient-reported scale is an important supplement for a given period. MG-ADL has a better response to severe disease, and MG-QOL15r is more comprehensive for patients in remission or minimal manifestation status.
- |||||||||| Firdapse (amifampridine) / BioMarin, Catalyst Pharma
Journal: Lambert-Eaton myasthenic syndrome revealed after surgery of lung adenocarcinoma. (Pubmed Central) - Oct 5, 2021 One month later patient present a muscle weakness in both lower limbs and fatigability followed by an inability to walk. The diagnosis of LEMS was made from the distinctive electromyogram (EMG) findings and a treatment with Amifampridine (3, 4-diaminopyridine phosphate [3, 4-DAP]) was prescribed with evident efficacy for symptoms.
- |||||||||| Subxyphoidal single-port thymectomy for myasthenia gravis with thymic hyperplasia (Carl-Zeiss-Saal, right (ground floor)) - Oct 2, 2021 - Abstract #DGT2021DGT_167;
The minimally invasive subxiphoidal single-port thymectomy is a safe, gentle and cosmetically excellent procedure for the multidisciplinary treatment of myasthenia gravis. Furthermore, the indication for surgery should also be made for thymus hyperplasia in combination with myasthenia gravis as it can lead to an improvement in the clinical symptoms.
- |||||||||| 9 year results after the introduction of thymus surgery (Carl-Zeiss-Saal, right (ground floor)) - Oct 2, 2021 - Abstract #DGT2021DGT_166;
The thymectomy can be performed thoracoscopically with a high degree of security for the patient. Multiple resections of thymomas are also possible and can be carried out with a good prognosis for the patient, which speaks in favor of a correspondingly tight follow-up regime for this tumor entity.
- |||||||||| Clinical, Retrospective data, Journal: Clinical features and outcome of acquired myasthenia gravis in 94 dogs. (Pubmed Central) - Oct 2, 2021
Multiple resections of thymomas are also possible and can be carried out with a good prognosis for the patient, which speaks in favor of a correspondingly tight follow-up regime for this tumor entity. Clinical remission in MG is less likely in older dogs and dogs presenting with regurgitation or high initial AChR Ab concentration, but more likely in younger dogs and dogs with comorbid endocrine disease.
- |||||||||| prednisolone / Generic mfg.
Biomarker, Journal: Long-term outcomes and prognostic factors in generalized myasthenia gravis. (Pubmed Central) - Sep 30, 2021 Approximately 60% of the MG patients achieved the treatment goal within 2 years after treatment. PSL dose and the cumulative number of plasmapheresis procedures at 3 months after immunotherapy initiation may help identify treatment-resistant patients with MG.
- |||||||||| prednisone / Generic mfg.
Journal: Chronic low-dose intravenous immunoglobulins as steroid-sparing therapy in myasthenia gravis. (Pubmed Central) - Sep 30, 2021 PSL dose and the cumulative number of plasmapheresis procedures at 3 months after immunotherapy initiation may help identify treatment-resistant patients with MG. This retrospective study demonstrates that chronic low-dose IVIg treatment in patients with MG improves clinical outcomes and has a prolonged and significant steroid-sparing effect over a period of 3 years.
- |||||||||| azithromycin / Generic mfg.
Clinical, Journal: Myasthenia gravis and COVID-19: A case series and comparison with literature. (Pubmed Central) - Sep 30, 2021 The results from our study suggest that prior MG activity could partially influence the subsequent clinical outcomes. It emerged also that ongoing long-term immunosuppressive immunotherapy to MG should be maintained during the COVID-19 pandemic and that AZM can be used safely in MG patients and concurrent COVID-19 infection.
- |||||||||| Fraxiparine (nadroparin) / Aspen
Clinical, Review, Journal: Myasthenia gravis and covid-19 in pregnancy: a review of the literature and case series report. (Pubmed Central) - Sep 29, 2021 Based on our observations in this study it would seem that the coexistence of MG and COVID-19 infection in pregnancy does not elicit exacerbation in neither of those conditions. Further research is needed to confirm or challenge these findings, especially with the prospects of new virus variants emerging in the future.
- |||||||||| Review, Journal: Roles of cytokines and T cells in the pathogenesis of myasthenia gravis. (Pubmed Central) - Sep 29, 2021
Regarding cytokines, interleukin 17 (IL-17; a Th17-related cytokine), IL-21 (a Tfh-related cytokine), the B-cell activating factor (BAFF; a B-cell-related cytokine), and a proliferation-inducing ligand (APRIL; a B-cell-related cytokine) have been reported to be upregulated and associated with clinical parameters of MG. This review focuses on the current understanding of the involvement of cytokines and lymphocytes in the immunological pathogenesis of MG, which may lead to the development of novel therapies for this disease in the near future.
- |||||||||| Clinical, Journal: Immunotherapy Use in Patients With Lung Cancer and Comorbidities. (Pubmed Central) - Sep 29, 2021
Immune checkpoint inhibitor use in individuals with solid organ transplant carries a substantial risk of organ rejection. Ongoing research into the prediction of ICI efficacy and toxicity may help in patient selection, treatment, and monitoring.
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