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Advances and challenges in the treatment of myasthenia gravis

Myasthenia gravis (MG) is a chronic autoimmune disease with fluctuating muscle weakness and fatigability. Standard immunomodulatory treatment may fail to achieve sufficient improvement with minimal symptom expression or remission of myasthenic symptoms, despite adequate dosing and duration of treatm...

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Detalles Bibliográficos
Autores principales: Schneider-Gold, Christiane, Gilhus, Nils Erik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8721395/
https://www.ncbi.nlm.nih.gov/pubmed/34987614
http://dx.doi.org/10.1177/17562864211065406
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author Schneider-Gold, Christiane
Gilhus, Nils Erik
author_facet Schneider-Gold, Christiane
Gilhus, Nils Erik
author_sort Schneider-Gold, Christiane
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description Myasthenia gravis (MG) is a chronic autoimmune disease with fluctuating muscle weakness and fatigability. Standard immunomodulatory treatment may fail to achieve sufficient improvement with minimal symptom expression or remission of myasthenic symptoms, despite adequate dosing and duration of treatment. Treatment-resistant MG poses a challenge for both patients and treating neurologists and requires new therapeutic approaches. The spectrum of upcoming immunotherapies that more specifically address distinct targets of the main immunological players in MG pathogenesis includes T-cell directed monoclonal antibodies that block the intracellular cascade associated with T-cell activation, monoclonal antibodies directed against key B-cell molecules, as well as monoclonal antibodies against the fragment crystallizable neonatal receptor (FcRn), cytokines and transmigration molecules, and also drugs that inhibit distinct elements of the complement system activated by the pathogenic MG antibodies. The review gives an overview on new drugs being evaluated in still ongoing or recently finished controlled clinical trials and drugs of potential benefit in MG due to their mechanisms of action and positive effects in other autoimmune disorders. Also, the challenges associated with the new therapeutic options are discussed briefly.
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spelling pubmed-87213952022-01-04 Advances and challenges in the treatment of myasthenia gravis Schneider-Gold, Christiane Gilhus, Nils Erik Ther Adv Neurol Disord Review Myasthenia gravis (MG) is a chronic autoimmune disease with fluctuating muscle weakness and fatigability. Standard immunomodulatory treatment may fail to achieve sufficient improvement with minimal symptom expression or remission of myasthenic symptoms, despite adequate dosing and duration of treatment. Treatment-resistant MG poses a challenge for both patients and treating neurologists and requires new therapeutic approaches. The spectrum of upcoming immunotherapies that more specifically address distinct targets of the main immunological players in MG pathogenesis includes T-cell directed monoclonal antibodies that block the intracellular cascade associated with T-cell activation, monoclonal antibodies directed against key B-cell molecules, as well as monoclonal antibodies against the fragment crystallizable neonatal receptor (FcRn), cytokines and transmigration molecules, and also drugs that inhibit distinct elements of the complement system activated by the pathogenic MG antibodies. The review gives an overview on new drugs being evaluated in still ongoing or recently finished controlled clinical trials and drugs of potential benefit in MG due to their mechanisms of action and positive effects in other autoimmune disorders. Also, the challenges associated with the new therapeutic options are discussed briefly. SAGE Publications 2021-12-21 /pmc/articles/PMC8721395/ /pubmed/34987614 http://dx.doi.org/10.1177/17562864211065406 Text en © The Author(s), 2021 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review
Schneider-Gold, Christiane
Gilhus, Nils Erik
Advances and challenges in the treatment of myasthenia gravis
title Advances and challenges in the treatment of myasthenia gravis
title_full Advances and challenges in the treatment of myasthenia gravis
title_fullStr Advances and challenges in the treatment of myasthenia gravis
title_full_unstemmed Advances and challenges in the treatment of myasthenia gravis
title_short Advances and challenges in the treatment of myasthenia gravis
title_sort advances and challenges in the treatment of myasthenia gravis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8721395/
https://www.ncbi.nlm.nih.gov/pubmed/34987614
http://dx.doi.org/10.1177/17562864211065406
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