Table of ContentsView AllTable of ContentsMedications and TherapiesEmergency TreatmentSurgery and ProceduresSelf-CareNext in Myasthenia Gravis GuideWhat Is Myasthenia Gravis?
Table of ContentsView All
View All
Table of Contents
Medications and Therapies
Emergency Treatment
Surgery and Procedures
Self-Care
Next in Myasthenia Gravis Guide
Treatments formyasthenia gravisinclude medications to help control and prevent symptoms related to muscle weakness and therapies during amyastheniccrisis (when symptoms worsen). Surgical removal of the thymus (a small lymphatic gland) may lessen the immune process that causes myasthenia gravis. You may also need treatment to alleviate vision or breathing complications.
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Medications and Therapies for Myasthenia Gravis
Prescription medications can help preventsymptoms of myasthenia gravisin several different ways. In myasthenia gravis, the immune system attacksacetylcholinereceptors.
Treatments for myasthenia gravis include the following medications.
Soliris (eculizumab): This medication is administered as a scheduled infusion, and it’s used for people who test positive for certainantibodies (a type of immune protein)in myasthenia gravis. Soliris inhibits proteins that activate the inflammatory response (complement proteins) that facilitate the attack on the neuromuscular junction in myasthenia gravis.
Zilbrysq (zilucoplan): This drug prevents the production of certain complement proteins that may promote the immune process of myasthenia gravis. You self-inject this drug daily.
Rystiggo (rozanolixizumab-noli):This drug prevents the survival of antibodies that target acetylcholine receptors in myasthenia gravis. It is administered as an infusion with scheduled doses.
Steroids, Azasan (azathioprine), Prograf (tacrolimus), cyclosporin,methotrexate, and other immunosuppressants: Medications that suppress the immune system are often used during a myasthenic crisis and sometimes to prevent symptoms. These treatments are nonspecific anti-inflammatory therapies that decrease immune activity in general—they are not specifically targeted to the immune proteins of myasthenia gravis.
Plasmapheresis: Aplasma exchange procedureis sometimes used during a myasthenic crisis to remove the antibodies causing an attack on the acetylcholine receptors. During this procedure, your blood is filtered to remove the antibodies, and the blood cells are returned to your body. Plasmapheresis may cause a drop in blood pressure.
Intravenousimmunoglobulin(IVIG):This treatment involves the infusion of healthy antibodies to prevent harmful immune activity. It is used during a myasthenic crisis.
Infusion TherapiesSome of the treatments for preventing symptoms of myasthenia gravis are injections or scheduled infusions. An infusion is given in your vein under medical supervision. You can learn to give yourself an injection with a needle placed under your skin.
Infusion Therapies
Some of the treatments for preventing symptoms of myasthenia gravis are injections or scheduled infusions. An infusion is given in your vein under medical supervision. You can learn to give yourself an injection with a needle placed under your skin.
Treatment Side Effects
You may need to talk to your healthcare provider about how to avoid infections. This could include avoiding contact with people you know are sick, wearing a mask when you know you will be in public, and getting your recommended immunizations.
Additionally, some of the treatments used for myasthenia gravis may cause allergic reactions.If you experience adverse reactions of any kind to myasthenia gravis treatments, be sure to tell your healthcare team.
Myasthenia gravis can lead to dangerous emergency situations if it affects your swallowing or breathing.Weak muscles can predispose you to choking, which can causeaspiration pneumoniaor may lead to dangerous airway blockage. Myasthenia gravis can make your muscles weak, affecting your ability to breathe.
With myasthenia gravis, your breathing can quickly become impaired, leading to dangerously low oxygen. During a myasthenic crisis, your healthcare team may monitor your oxygen level so you can have respiratory support if you can’t adequately breathe on your own.
How Myasthenia Gravis Is Diagnosed
Surgical Intervention and Procedures
If you have myasthenia gravis, you might need to have surgery. One type of surgery, thymectomy (removal of the thymus), is a treatment to prevent symptoms. Other surgical procedures can treat complications of the condition.
Thymectomy
The thymus glandmediates the body’s immune system. For some people with myasthenia gravis, surgical removal of the thymus gland is recommended to suppress the immune attack on the acetylcholine receptors.
Myasthenia gravis is associated with non-cancerous enlargement of the thymus gland, and sometimes, people with myasthenia gravis are found to have a cancerous tumor of the thymus.
You and your healthcare provider can discuss this option and decide whether it would benefit you.Thymectomycan be curative, but some people still need to take medication for myasthenia gravis after thymectomy.
Stem Cell Transplant
Stem cell transplantis a procedure that involves infusing healthy immature immune cells that will develop into mature immune cells. The transplanted cells are infused to replace the unhealthy immune cells. This procedure may allow you to take a lower dose of medication for myasthenia gravis.
Before having a stem cell transplant, you would need pretreatment with medication to suppress your immune system.
Surgical Treatment of Ocular and Breathing Complications
Ptosis(a droopy eyelid) can occur due to myasthenia gravis. If your eyelid is interfering with your vision, surgical treatment can help improve your vision.
In rare instances, when myasthenia gravis causes severe breathing problems, it may necessitate the placement of atracheostomy, a semipermanent breathing tube surgically placed in the neck.
Lifestyle factors are crucial to taking care of yourself when you have myasthenia gravis. This condition can cause you to be tired, and your symptoms can worsen after being active.
Exercise can be beneficial for maintaining your overall health, but getting enough rest is important as wekk.
You might be advised to eat slowly to avoid choking or aspiration—having food go down the airway instead of the esophagus. Or, you might benefit from swallow therapy to help you avoid this complication.
You may also need to consider using assistive devices to help you get around.These may include a cane, walker, or wheelchair. While you may not need an assistive device at home, you might need one for tiring situations—such as in an airport.
Summary
Myasthenia gravis is a chronicautoimmune diseasethat affects muscle movement. Treatments include medications for maintenance therapy and myasthenic crisis (when symptoms worsen). These therapies can suppress the immune process that causes symptoms or may prevent the breakdown of acetylcholine, a chemical that the body uses in muscle movement.
You may need emergency treatment for breathing or swallowing complications. Additionally, surgical removal of the thymus gland can help prevent the harmful immune process of myasthenia gravis.
You also need treatment if you develop complications, such as respiratory support for breathing problems. You have many treatment options for myasthenia gravis that can help control and prevent symptoms and alleviate complications.
6 Sources
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Kaminski HJ, Sikorski P, Coronel SI, Kusner LL.Myasthenia gravis: the future is here.J Clin Invest. 2024;134(12):e179742. doi:10.1172/JCI179742
Alhaidar MK, Abumurad S, Soliven B, Rezania K.Current treatment of myasthenia gravis.J Clin Med.2022;11(6):1597. doi:10.3390/jcm11061597
Boccia VD, Boffa G, Inglese M.HSCT for stiff person syndrome and myasthenia gravis.Handb Clin Neurol.2024;202:239-247. doi:10.1016/B978-0-323-90242-7.00020-1
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