Myasthenia gravis (MG) is estimated to affect up to 60 000 Americans and over 700 000 people worldwide, though rates are likely even higher because the disease remains underdiagnosed. The prognosis for patients with MG has improved in recent years, due largely to the increasing use of immunomodulating therapies.
However, despite widespread agreement on the use of many MG treatments, there is still no universal standard of care to help guide clinicians. Because of the heterogeneous nature of the disease, no particular treatment approach is optimal for all patients with MG, and most physicians do not treat it often enough to be familiar with the full range of treatment options. Additionally, the “few successful clinical trials in MG have limited generalizability, and even the best of clinical trials cannot balance the use of different available and accepted treatment modalities in a disease as heterogeneous as MG,” explained Donald B. Sanders, MD, a professor of neurology at Duke University School of Medicine in Durham, North Carolina.
As a result of these factors, few “treatments used for MG have Class I evidence of efficacy, and it is
