Reimagining Myasthenia Gravis Care: Current Strategies and New Developments

Abstract

Myasthenia gravis (MG) is an autoimmune disease caused by autoantibodies targeting proteins on the neuromuscular junction. Around 85% of patients have antibodies against the muscle acetylcholine receptor (AChR), while up to 10% have antibodies against the muscle-specific kinase (MuSK). Rarer forms of the condition are low-density lipoprotein receptor-related protein 4 (LRP4) positive MG, and seronegative MG, in which no AChR, MuSK, or LRP4 autoantibodies are detected. MG, which can be ocular or generalised, is characterised by muscle weakness, which can be severe and debilitating. Despite advances in treatment, a significant proportion of patients living with generalised MG (gMG) continue to experience symptoms and poor quality of life (QoL). During this symposium, John Vissing, Professor of Neurology at the University of Copenhagen, and Director of the Copenhagen Neuromuscular Centre, Denmark; Heinz Wiendl, Professor of Neurology at the University of Münster, Germany; and Kristl Claeys, Professor of Neurology at the University of Leuven, Belgium, discussed the current challenges and future potential of MG treatments. They emphasised the need for patient-centred evaluations, discussed the pathophysiology, and highlighted the challenges of current immune therapies. They also explained how new generations of targeted immune therapies, such as neonatal Fc receptor (FcRn) inhibitors, could help tackle this area of unmet need by potentially ameliorating disease manifestations.