Symptomatic, pharmacological treatment of myasthenia gravis.

Abstract

Myasthenia gravis (MG) is a chronic antibody-mediated autoimmune disease. The most frequent form is MG with antibodies directed against the acetylcholine receptor on the postsynaptic membrane. The first step in the treatment of autoimmune myasthenia gravis consists of symptomatic therapy. If this is insufficiently effective, the next step is to start immunosuppressive treatment with corticosteroids, usually prednisolone. A corticoid-sparing agent is often added because of the long long-term side effects of high doses of corticosteroids. The position of emerging immunomodulatory therapies targeting B-and T-cells, the complement cascade, the neonatal Fc receptor, and cytokines associated with antibody production in the treatment of MG is currently unclear. However, it is likely that symptomatic treatment will remain the cornerstone in the management of patients with MG in the foreseeable future. In this review, we provide an overview of currently available symptomatic treatments and recent advances in this field.