healthcare professional
The treatment a patient receives following a gMG diagnosis will depend on the cause of damage at the NMJ – anti-AChR antibodies or anti-MuSK antibodies – and if they have thymoma.1
Over time, and with the right therapy, patients may experience an improvement in their symptoms and some may achieve remission or minimal manifestation status.*2
Generally, patients recently diagnosed with gMG take an acetylcholinesterase inhibitor and glucocorticoids to control their symptoms.2–4 Some patients cannot tolerate or do not respond to these treatments, in which case other options can be considered.2–4
The main complication to consider with gMG patients is a myasthenic crisis, which can be caused by other acute illnesses, infections and stress.†5 In these cases IVIg and PE can be used.2
Patients should be educated on the importance of avoiding stress, extreme physical exertion, infection and worsening of chronic medical illness and drugs to lower their risk of exacerbation and crisis.5,6
"You don’t know how you will feel from one day to the next or what the future holds"7
"You feel it from the moment you wake up and you have to adjust your routines and expectations, I live day by day"7
"Right now, right now the realistic goal is to not be any worse than I am now. You know, just kind of keep things stabilised and stay there"8
* Minimal manifestation status is defined as: No symptoms, but some minor clinical signs like mild orbicularis oculi or hip flexor weakness.2
† Defined as weakness necessitating intubation and mechanical ventilation.4AChR, acetylcholine receptor; gMG, generalised myasthenia gravis; IVIg, intravenous immunoglobulin; MG, myasthenia gravis; MuSK, muscle-specific kinase; NMJ, neuromuscular junction; PE, plasma exchange.