What is in the Neuromuscular Junction Literature?
The review begins with epidemiology studies that show an increased incidence of later onset myasthenia gravis (MG) and higher short-term mortality rates, especially in females, compared with the general population in Denmark. In the United States, a study showed increased mortality especially in older patients, and there was racial disparity. In France, a study showed higher mortality with male gender, older age, and higher comorbidities. Economic burden is addressed in another article. Regarding clinical features, light sensitivity in MG is discussed along with differentiating thyroid eye disease symptoms and signs from those of ocular MG. MG-specific measures are highlighted with consensus recommendations for their use. Several articles contain data regarding diagnostic laboratory assays and test sensitivity and specificity among other measures. The role of thymectomy in older patients with MG is considered. The medical treatment section addresses corticosteroid regimens, intravenous immunoglobulin as maintenance therapy, a phase 3 study of the recently approved neonatal Fc receptor (FcRN) blocker nipocalimab, use of complement inhibitors and FcRN blockers in general, regimens for efgartigimod, and positive studies on the interleukin-16 receptor monoclonal antibody (Ab) satralizumab and the CD19 B-cell-depleting monoclonal Ab inebilizumab.