Abstract-Text (inkl. Referenzen)

Introduction

Myasthenia gravis (MG) is an autoimmune disease. Specific antibodies occur in MG with the majority of patients presenting with Acetylcholine-Receptor-antibodies (AchR+-MG). The aim of this study is to outline current treatment in MG against the background of recently emerged therapeutic strategies.

Methods

All MG patients presenting between January 2019 until October 2022 at least twice in our neurological University department were included in this retrospective analysis. Medical records (including all data before 2019) were assessed longitudinally.

Results

Of 81 patients (37 female, median age 63 years), 54,3% initially had generalised MG, 88,9% had antibodies. 20 patients (24,7%) required hospital admission due to clinical worsening with plasmapheresis/IVIG. Medication in AchR+-MG-patients (n=67, median therapy=26 months, median visits=8) comprised azathioprine (n=51), mycophenolate-mofetil (n=13), methotrexate, rituximab or regular IVIG (n=1, respectively). 59 received prednisolone (of which monotherapy n=7). Excluding prednisolone, 49 required only one, 6 needed 2 and 2 patients ≥3 different immunosuppressants, 3 received no immunosuppression.

Conclusion

Whilst the majority of AchR+-MG-patients is being sufficiently treated with first-line immunosuppression, few patients require intensified treatment and could profit from newly emerged, yet cost-intensive therapies. Close monitoring to identify a lack of stability can help to select suitable patients.