New Therapeutic Agents in Myasthenia Gravis

Myasthenia gravis (MG) is an autoantibody-mediated neuromuscular junction disorder characterized by fatigable muscle weakness. Mainstay therapies for MG include anticholinesterase inhibitor, thymectomy, corticosteroids, and non-specific immunotherapy, such as azathioprine, tacrolimus, mycophenolate mofetil, intravenous immunoglobulin, and plasma exchange. These therapeutic methods have significantly improved MG treatment in recent decades. However, there are still some patients with MG refractory to conventional treatments. In addition, long-term use of corticosteroids and non-specific immunosuppressants can lead to serious complications, including metabolic derangement, infections, malignancies, and systemic organ dysfunction. Recently, new therapeutic agents have been developed based on advancements in our understanding of the immunopathogenesis of MG. These agents are more specific and have a more rapid effect compared with conventional treatments. This article reviews novel therapeutic agents and their scientific basis.