DISEASE & TREATMENT
Understanding the MG Treatment Landscape
A people-friendly overview of currently used treatments for myasthenia gravis (MG).
This article is intended for educational purposes only and not as medical advice. It’s important to talk to your doctor regularly about any questions you have, including sharing your symptoms so they can develop the treatment plan that’s right for you.
In an effort to create more uniform, globally accepted standards of care for people living with MG, in 2013 the Myasthenia Gravis Foundation of America (MGFA) created a Task Force with the mission of providing MG treatment recommendations. The Task Force was made up of 15 international experts in treating MG, and they published international consensus guidance for the management of MG in 2016.1
In this article, we introduce the recommendations, as established in the MG treatment guidelines. Developed by an international group of MG experts, these guidelines are intended to be a guide for clinicians caring for people living with myasthenia gravis worldwide.1
Make sure to always consult your healthcare team with any questions about your treatment plan and goals.
Anticholinesterase inhibitors (ACIs)
Anticholinesterase inhibitors or ACIs help prevent the breakdown of chemical signals sent between nerves and muscles, which may help improve muscle weakness.2
Speak with your doctor for more information about anticholinesterase inhibitors.
Steroids are often used to treat MG.3, 4 These medicines are used to minimize (suppress) production of antibodies that can cause weakness. Ask your doctor for more information about steroids.
Immunosuppressive therapies (ISTs)
You may have heard of “ISTs” during your treatment journey. ISTs stand for immunosuppressive therapies and are also referred to as non-steroidal ISTs, because they are a type of medication that do not contain steroids.5 ISTs are commonly used in the treatment of MG, as recommended in the MG treatment guidelines.3 Speak with your doctor to learn more about ISTs.
Bloodstream therapies, such as IVIg and plasma exchange, are also used to treat some kinds of MG, as recommended in the guidelines, by placing healthy antibodies into the blood.6 One bloodstream therapy is a blood-cleansing technique that filters out harmful antibodies your body made.7
Ask your doctor for more information about bloodstream therapies.
According to the MG treatment guidelines, people who are diagnosed with generalized myasthenia gravis (gMG) are evaluated for an operation called a thymectomy, which is the removal of the thymus gland, located just under the breastbone.1,8
Talk to your doctor if you have questions about thymectomy.
Biologic therapy is another type of treatment currently used for gMG. They are created from living things or the products of living things. Currently, biologic treatment in gMG is primarily administered through infusions.9
Talk to your doctor if you have questions about biologic therapies.
The treatment landscape can be a lot to understand, especially when dealing with your myasthenia gravis diagnosis. Be sure to talk to your doctor about any questions you may have. You might find this discussion guide helpful at your next doctor’s appointment.
In addition to questions you might have on the treatment landscape, you may also want to consider talking to your doctor about the following:
- Diet and nutrition come with some special challenges for people with MG. MG United also has information on healthy diets, saving energy at mealtimes, preparing meals that are intended to make chewing and swallowing easier.
- Exercise should be adapted to fit with the symptoms of MG. Consider yoga and walking. Talk to your doctor before starting any exercise program.10,11
- Talking to others can help with feelings of isolation and frustration. Just chatting with a person that understands what you are going through or connecting with someone in the MG community may help. Learn more about explaining MG to others.
- Narayanaswami P, et al. Neurology. 2021;96;114-122.
- Gilhus NE, et al. Lancet Neurol. 2015;14(10):1023-1036.
- Sanders DB, et al. Neurology. 2016;87(4):419-425.
- Gilhus NE. N Engl J Med. 2016;375(26):2570-2581.
- Mantegazza R, et al. Neuropsychiatr Dis Treat. 2011;7:151-160.
- Kim JY, et al. J Clin Neurol. 2011;7(4):173-183.
- Kumar R, et al. Indian J Crit Care Med. 2015;19(1):9-13.
- Masaoka A, et al. Ann Thorac Surg. 1996;62(3):853-859.
- Dalakas MC. Curr Opin Neurol. 2020;33:545-552.
- Gilhus NE, et al. Nat Rev Dis Prim. 2019;5(1):1-19.
- Mikkelsen K, et al. Maturitas. 2017;106:48-56.
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