Myasthenia Gravis

A disorder of neuromuscular transmission characterized by weakness of cranial and skeletal muscles. Autoantibodies directed against acetylcholine receptors damage the motor endplate portion of the NEUROMUSCULAR JUNCTION, impairing the transmission of impulses to skeletal muscles. Clinical manifestations may include diplopia, ptosis, and weakness of facial, bulbar, respiratory, and proximal limb muscles. The disease may remain limited to the ocular muscles. THYMOMA is commonly associated with this condition. (Adams et al., Principles of Neurology, 6th ed, p1459)

Also Known As:

Networked: 5508 relevant articles (318 outcomes, 420 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Thymoma (Thymic Carcinoma)
2.	Multiple Sclerosis
3.	Polyneuropathies (Polyneuropathy)
4.	Dermatomyositis (Dermatopolymyositis)
5.	Systemic Lupus Erythematosus (Libman-Sacks Disease)

Experts

1.	Vincent, Angela: 61 articles (08/2015 - 01/2002)
2.	Berrih-Aknin, Sonia: 36 articles (08/2015 - 07/2003)
3.	Tzartos, Socrates J: 33 articles (11/2014 - 07/2002)
4.	Motomura, Masakatsu: 29 articles (09/2015 - 10/2002)
5.	Christadoss, Premkumar: 27 articles (12/2015 - 01/2002)
6.	Kaminski, Henry J: 25 articles (02/2016 - 03/2002)
7.	Evoli, Amelia: 25 articles (08/2015 - 01/2002)
8.	Vincent, A: 22 articles (08/2015 - 04/2000)
9.	Sanders, Donald B: 22 articles (05/2015 - 01/2002)
10.	Le Panse, Rozen: 21 articles (08/2015 - 05/2005)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Myasthenia Gravis:

1.	Intravenous Immunoglobulins (IVIG)FDA Link 01/01/2008 - "A study with 15 participants with mild or moderate myasthenia gravis found no statistically significant difference in efficacy of IVIg and placebo after six weeks. " 05/01/2015 - "IVIG and PLEX are equally effective in worsening myasthenia gravis. " 05/01/2000 - "Treatment by IVIg is effective in acute forms of myasthenia gravis. " 04/01/2002 - "IVIg is a safe and effective adjunctive treatment for myasthenia gravis, but there are no well established guidelines for the use of IVIg in this disease, lacking controlled randomized trials to assess its efficacy in homogeneous group of patients. " 03/15/2014 - "There is insufficient data on the efficacy of intravenous immunoglobulins (IVIg) as maintenance treatment in myasthenia gravis (MG). "
2.	Acetylcholine (Acetylcholine Chloride)FDA Link 06/01/1990 - "Improved radioassay of anti-acetylcholine receptor antibody: application for the detection of extremely low antibody titers in sera from patients with myasthenia gravis." 09/01/1994 - "The results suggest that anti-CD4 antibody administration could be effective in the treatment of severe myasthenia gravis and indicate that acetylcholine receptor-specific T lymphocytes might contribute to the disturbed neuromuscular transmission in the disease." 07/01/2013 - "This cross-sectional case control study included subjects aged between 18 and 65 years with diagnosis of myasthenia gravis (MG) in Osserman's Stage I and Stage IIa and those in remission with positive and negative acetylcholine receptor antibody (AChRAb). " 01/01/2012 - "Recently, the prognosis of myasthenia gravis (MG) has improved considerably because the commercial measurement of acetylcholine receptor (AChR) antibody has been introduced and early treatment with steroid at large quantities has been utilized. " 04/01/2002 - "Although improvement usually parallels decrease in acetylcholine receptor antibody (AChRAb) levels and jitter values, there is a question what factors influence immunological and electrophysiological remission in a population of myasthenia gravis (MG) patients. "
3.	Immunoglobulins (Immunoglobulin)IBA 01/01/2006 - "The third study with 15 participants with mild or moderate myasthenia gravis found no statistically significant difference in efficacy of intravenous immunoglobulin and placebo after six weeks. " 10/01/1989 - "A four-year-old girl with the ocular type of myasthenia gravis was effectively treated with intravenous high dose human immunoglobulin. " 01/01/2008 - "The objective of this review was to examine the efficacy of intravenous immunoglobulin for treating exacerbations of myasthenia gravis or for chronic myasthenia gravis. " 09/01/2007 - "Intravenous immunoglobulin improved clinical outcomes in patients with myasthenia gravis and worsening weakness." 01/01/2006 - "The objective of this review was to examine the efficacy of intravenous immunoglobulin for treating exacerbations of myasthenia gravis or for chronic myasthenia gravis. "
4.	Cholinesterase Inhibitors (Anticholinesterases)IBA 01/01/2014 - "To evaluate the efficacy of acetylcholinesterase inhibitors in all forms of myasthenia gravis. " 01/01/2011 - "To evaluate the efficacy of acetylcholinesterase inhibitors in all forms of myasthenia gravis. " 01/01/2014 - "We did not find any large randomised or quasi-randomised trials of acetylcholinesterase inhibitors in generalised myasthenia gravis either for the first version of this review or this update. " 01/01/2011 - "We did not find any large randomised or quasi-randomised trials of acetylcholinesterase inhibitors in generalised myasthenia gravis. " 03/01/2010 - "Preparation and in vitro screening of symmetrical bispyridinium cholinesterase inhibitors bearing different connecting linkage-initial study for Myasthenia gravis implications."
5.	AntibodiesIBA 01/01/2015 - "Our data confirm LRP4 as a new autoimmune target, supporting the value of including anti-LRP4 antibodies in further studies on Myasthenia gravis." 09/01/2010 - "This study aimed to detect multiple antibodies in myasthenia gravis and to investigate its clinical significance. " 08/01/2004 - "In order to study the potential roles of IFN alpha and its antagonists in autoimmune phenomena, the sera from 89 patients (aged 15-95 years, 65 females) diagnosed as having myasthenia gravis (MG) (2 months to 34 years duration) were tested for the presence of natural anti-IFN alpha-2b auto-antibodies. " 01/01/2000 - "Study of anti-striational and anti-thyroid antibodies in patients with myasthenia gravis." 05/01/1991 - "[Study of antibodies to motor end-plate in ocular myasthenia gravis]."
6.	Tacrolimus (Prograf)FDA LinkGeneric 05/01/2013 - "Effective treatment of a 13-year-old boy with steroid-dependent ocular myasthenia gravis using tacrolimus." 12/06/2011 - "[Therapeutic efficacy and safety of tacrolimus for intractable myasthenia gravis: a report of 36 patients]." 08/15/2006 - "To elucidate the long-term therapeutic efficacy and safety of low-dose FK506 (tacrolimus) in patients with myasthenia gravis (MG). " 08/15/2006 - "Long-term therapeutic efficacy and safety of low-dose tacrolimus (FK506) for myasthenia gravis." 12/01/2003 - "We studied the therapeutic effects of FK506 and noted improvement in 7 of 13 myasthenic patients on the clinical muscle test (myasthenia gravis, MG score). "
7.	Prednisolone (Predate)FDA LinkGeneric 11/18/1978 - "Five patients, four of them with severe or severe generalized myasthenia gravis, were treated by long term orally administrated prednisolone, with following results: one complete remission and two almost complete remissions (in three aged fernale patients), two substantial improvements (one in a male patient, one in a young adult female patient, both thymectomized). " 07/15/2009 - "Interestingly, Treg cells from prednisolone-treated myasthenia gravis patients showed an improved suppressive function compared with untreated patients, suggesting that prednisolone may play a role in the control of the peripheral regulatory network. " 05/01/2015 - "The aim of this study was to elucidate the effectiveness of oral prednisolone (PSL) according to dosing regimen in 472 patients with myasthenia gravis (MG). " 04/01/2013 - "The effect of early prednisolone treatment on the generalization rate in ocular myasthenia gravis." 01/01/2013 - "Perioperative high-dose prednisolone therapy is a safe, promising strategy for managing patients with myasthenia gravis and may reduce the incidence of postoperative crisis while improving disease status."
8.	Prednisone (Sone)FDA LinkGeneric 12/01/2006 - "Prednisone-induced exacerbation was defined as a significant reduction in a patient's Myasthenia Gravis Severity Scale (MSS) score within 4 weeks of prednisone administration. " 07/15/1990 - "Clinical and laboratory findings supported a diagnosis of myasthenia gravis, and the dog had clinical improvement in response to prednisone treatment. " 01/01/1987 - "In a selected group of 69 patients with myasthenia gravis treated with prednisone, the factors were studied that might have influenced the reoccurrence or exacerbation of clinical signs after initial improvement in two-thirds of the patients. " 08/05/2008 - "This may be due to greater than predicted benefit from the prednisone dosage used, the short duration of the study, or the absence of any benefit of MMF in this population of patients with myasthenia gravis." 01/01/2005 - "Two double-blind trials compared prednisone with placebo for generalised myasthenia gravis. "
9.	Adrenal Cortex Hormones (Corticosteroids)IBA 12/01/2006 - "Although oral corticosteroids are effective for the treatment of myasthenia gravis (MG), the possibility of steroid-induced exacerbation of symptoms, especially during the initial course of steroid therapy, has limited their use patients with severe MG. However, the factors influencing or predicting in exacerbation are not well understood. " 12/01/1985 - "Corticosteroids have been useful in the management of myasthenia gravis (MG), but their efficacy has been limited by the slow onset of improvement, initial worsening of MG, refractoriness of some patients, and side effects of large daily doses. " 05/01/2013 - "Many patients with myasthenia gravis (MG) still find it difficult to maintain daily activities due to chronic residual fatigability and long-term side effects of oral corticosteroids, since full remission is not common. " 01/01/2013 - "The aim of this study was to delineate the status of oral corticosteroid therapy in myasthenia gravis (MG), and to elucidate the effectiveness of oral corticosteroids according to dosing regimen. " 09/01/2014 - "Myasthenia gravis is an important indication for the long-term prescription of corticosteroids. "
10.	rituximab (Mabthera)FDA Link 06/01/2011 - "Rituximab at a dose of 1 g appears to be beneficial in the treatment of patients with severe myasthenia gravis. " 06/01/2011 - "In a relatively large, unselected group of patients with myasthenia gravis and LEMS, rituximab treatment resulted in a significant clinical improvement in two-thirds of cases. " 05/01/2015 - "Efficacy and safety of rituximab for myasthenia gravis: a systematic review and meta-analysis." 04/01/2014 - "We characterized IL-10-producing B (B10) cells in myasthenia gravis (MG) patients and correlated them with disease activity and responsiveness to rituximab therapy. " 08/01/2013 - "Changes in regulatory T cells after rituximab in two patients with refractory myasthenia gravis."

Therapies and Procedures

1.	Thymectomy 11/01/2002 - "Thymectomy is considered the most effective treatment for achieving sustained improvement as well as remission in patients with myasthenia gravis (MG), and most neurologists favor the use of this procedure. " 01/01/2002 - "Early thymectomy carries the best results in Myasthenia Gravis and every effort should be made to shorten the preoperative duration for both thymomatous and nonthymomatous patients. " 01/01/2002 - "Early thymectomy carries the best results in Myasthenia Gravis and every effort should be made to shorten the preoperative duration for both thymomatous and nonthymomatous patients. " 01/01/1991 - "In recent years, thymectomy has gained increasing acceptance as the most effective treatment for acheiving sustained improvement in patients affected of myasthenia gravis. " 11/18/1990 - "Childhood myasthenia gravis gave the best results but thymectomy was beneficial in the combined group, in long-lasting myasthenia and in tumourous cases, too. "
2.	Plasma Exchange 01/01/2002 - "On the other hand,experience from many non-randomised studies suggests that plasma exchange is beneficial in myasthenia gravis. " 05/01/1981 - "Antibody-negative acquired myasthenia gravis: successful therapy with plasma exchange." 04/01/2013 - "Plasma exchange (PLEX) is effective in myasthenia gravis (MG), but there are concerns about its safety. " 04/01/1991 - "A short plasma exchange protocol is effective in severe myasthenia gravis." 07/01/1984 - "These cases illustrate that long-term plasma exchange is feasible and effective in selected exchange-dependent patients with myasthenia gravis."
3.	Plasmapheresis 12/01/1999 - "Besides of these therapies, plasmapheresis and immunoadsorption plasmapheresis extremely improved mortality in myasthenia gravis. " 08/01/1994 - "Plasmapheresis (PMP) is effective in some clinical situations of myasthenia gravis (MG). " 03/01/1999 - "The aim of this study was to compare the efficacy of different protocols of plasmapheresis in the treatment of myasthenia gravis (MG). " 12/21/2010 - "To examine the prognostic factors and efficacy of myasthenia gravis (MG) in crisis on plasmapheresis and detect the reasons for ineffective plasmapheresis. " 04/01/1991 - "We have investigated the efficacy of a short plasmapheresis protocol of two exchanges 1 day apart in a series of 70 patients with severe forms of myasthenia gravis. "
4.	Aftercare (After-Treatment) 01/01/2008 - "Despite complete remission after treatment, the patient developed myasthenia gravis with ptosis and neck drop symptoms. " 05/01/2009 - "Fifteen patients had a thymus-related syndrome (in 13 patients it resulted myasthenia gravis), and in 11 patients it improved or remitted after treatment of the pleural recurrence. " 05/01/2015 - "Primary outcome measure was functional status at 14 days after treatment, as assessed by the Quantitative Myasthenia Gravis Score. " 01/01/2009 - "A case of vitiligo vulgaris showing a pronounced improvement after treatment for myasthenia gravis." 10/01/1996 - "Autoimmune encephalopathy after treatment of thymoma-associated myasthenia gravis."
5.	Drug Therapy (Chemotherapy) 12/01/1999 - "After chemotherapy and mediastinal irradiation, the patient is now in complete remission of myasthenia gravis and is recurrence-free 15 months after surgery." 03/20/2006 - "Myasthenia gravis and a rare complication of chemotherapy - clarification and acknowledgement." 06/01/2005 - "The presence of myasthenia gravis (p = 0.04) and neoadjuvant chemotherapy (p = 0.004) affected survival significantly. " 03/01/2005 - "One of these was affected by myasthenia gravis, and was treated preoperatively with concurrent radio-chemotherapy and lymphocytopheresis. " 02/07/2005 - "Myasthenia gravis and a rare complication of chemotherapy."