Advances in treating myasthenia gravis

Myasthenia gravis (MG) is a prototypical antibody-mediated autoimmune disease affecting various targets at the postsynaptic membrane of the neuromuscular junction. Conventional treatments including pyridostigmine, immunosuppression, immunomodulation, and thymectomy have dramatically reduced mortality and improved disease control. However, the conventional approach is not always successful in reducing the burden of disease and minimizing side effects among MG patients. In the past 10 years, there have been major advances in the therapeutic approach to myasthenia gravis regarding thymectomy, eculizumab, and rituximab that already impact clinical practice. We also review ongoing investigations of novel treatment approaches including neonatal Fc receptor inhibition, subcutaneous immunoglobulin, and 3,4-diaminopyridine that will further advance the management of MG in the next decade.