This site is intended for US healthcare professionals only For Patients
This site is intended for US healthcare professionals only For Patients
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UNCONTROLLED gMG CAN BE A DAILY STRUGGLE
Patients with uncontrolled generalized myasthenia gravis (gMG) cope daily with debilitating moderate-to-severe symptoms and the ongoing risk of serious events–despite being on treatment.1-7
THE HALLMARKS OF UNCONTROLLED gMG
~50%of patients(N=1140)
had moderate-to-severe gMG, defined as having a Myasthenia Gravis Activities of Daily Living (MG-ADL) score of 6 or above1*
26%of patients(N=372)
required IVIg within a 6-month period due to exacerbations or inability to reduce maintenance therapy8
~20%of patients(N=188)
will experience a potentially life-threatening myasthenic crisis requiring intubation at least once during their lifetime7,13
36%of patients(N=372)
report their treatments impact their ability to lead a normal life8
50-77%of patients(n=398)
50% of men and 77% of women reported intolerable side effects while taking prednisone10
UP TO 50%of patients(N=1077)
reported current disease symptoms associated with an unsatisfactory symptom state3,6,12
For patients with chronically uncontrolled gMG, instability and unpredictability are ever present.4,9
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79-90% of patients never reach complete stable remission13,14‡ (n=677)
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Fluctuations can be spontaneous, varying from day to day and from hour to hour9
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INITIAL
~2-3 years
After being diagnosed, symptoms typically worsen, reaching their peak within the first 2 years. But for 1 in 5 people, worsening symptoms may continue after 2 years.4
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CONTINUAL
After the initial stage, people may continue to experience unpredictable and serious symptoms.1,7,15
EXACERBATIONS ARE UNPREDICTABLE
Although some triggers of intermittent worsening of symptoms have been identified, they are not well understood, making the disease experience feel unpredictable for patients.4,9
IDENTIFIED TRIGGERS INCLUDE4,16:
Mental and physical stress
Seasonal changes
Infections
Certain medications
Vaccinations
21-43%of patients
experienced ER visits and hospitalizations over the course of 6 months7‡ (n=76-741)
69% of patients
who experienced a myasthenic crisis have no identified precipitating factor11 (n=188)
Cutter G, Xin H, Aban I, et al. Cross-sectional analysis of the Myasthenia Gravis Patient Registry: disability and treatment. Muscle Nerve. 2019;60(6):707-715.
Tran C, Biswas A, Mendoza M, Katzberg H, Bril V, Barnett C. Performance of different criteria for refractory myasthenia gravis. Eur J Neurol. 2021;28(4):1375-1384.
Petersson M, Feresiadou A, Jons D, et al. Patient-reported symptom severity in a nationwide myasthenia gravis cohort. Neurology. 2021;97:e1382-e1391.
Grob D, Brunner N, Namba T, Pagala M. Lifetime course of myasthenia gravis. Muscle Nerve. 2008;37(2):141-149.
Silva, P. MG patients satisfied with treatment, but quality of life could be better, US survey shows. Myasthenia Gravis News. June 17, 2021. Accessed April 14, 2022. https://myastheniagravisnews.com/news-posts/2021/06/17/mg-patients-want-better-quality-of-life-us- survey-shows/?cn-reloaded=1
Mendoza M, Tran C, Bril V, Katzberg HD, Barnett C. Patient-acceptable symptom states in myasthenia gravis. Neurology. 2020;95(12):e1617-e1628.
Xin H, Harris LA, Aban IB, Cutter G. Examining the impact of refractory myasthenia gravis on healthcare resource utilization in the United States: analysis of a Myasthenia Gravis Foundation of America patient registry sample. J Clin Neurol. 2019;15(3):376-385.
Lee I, Kaminkski H, McPherson T, et al. Gender differences in prednisone adverse effects Survey result from the MG registry. Neurol Neuroimmunol Neuroinflamm. 2018; 5:e507.
Werneck LC, Scola RH, Germiniani FM, Comerlato EA, Cunha FM. Myasthenic crisis: report of 24 cases. Arq Neuropsiquiatr. 2002;60(3-A):519-526.
Andersen L, Jakobsson A, Revsbech, K, Vissing J. Causes of symptom dissatisfaction in patients with generalized myasthenia gravis. J Neurol. Published online November 21, 2021. doi:10.1007/s00415-021-10902-1
Baggi F, Andreetta F, Maggi L, et al. Complete stable remission and autoantibody specificity in myasthenia gravis. Neurology. 2013;80(2):188-195.
Imai T, Utsugisawa K, Murai H, et al. Oral corticosteroid dosing regimen and long-term prognosis in generalised myasthenia gravis: a multicentre cross-sectional study in Japan. J Neurol Neurosurg Psychiatry. 2018;89(5):513-517.
Kaminski HJ, Kusner LL. Myasthenia Gravis and Related Disorders. 3rd ed. Humana Press. 2018.
Blum S, Lee D, Gillis D, McEniery DF, Reddel S, McCombe P. Clinical features and impact of myasthenia gravis disease in Australian patients. J Clin Neurosci. 2015;22(7):1164-1169.
Anil R, Kumar A, Alaparthi S, et al. Exploring outcomes and characteristics of myasthenia gravis: rationale, aims and design of registry–the EXPLORE-MG registry. J Neurol Sci. 2020;414:116830.
Lindstrom J, Seybold M, Lennon V, et al. Antibody to acetylcholine receptor in myasthenia gravis. Neurology. 1976;26:1054-1059.
Vincent A, Newson-Davis J. Acetylcholine receptor antibody as a diagnostic test for myasthenia gravis: results in 153 validated cases and 2967 diagnostic assays. J Neurol Neurosurg Psychiatry. 1985;48:1246-1252.
Burden SJ, Yumoto N, Zhang W. The role of MuSK in synapse formation and neuromuscular disease. Cold Spring Harb Perspect Biol. 2013;5(5):a009167.
Nagane Y, Murai H, Imai T, et al. Social disadvantages associated with myasthenia gravis and its treatment: a multicentre cross-sectional study. BMJ Open. 2017;7(2):e013278.
Nowak RJ. Myasthenia gravis: challenges and burdens of disease. Neurology Reviews. March 2018. Accessed April 2022. https://www.neurologyreviews-digital.com/neurologyreviews/nord_supplement_0318/MobilePagedArticle.action articleId=1361082#articleId1361082
The CIE. The cost to patients and the community of Myasthenia Gravis. Centre for International Economics; November 2013. Accessed May 1, 2022. http://www.thecie.com.au/wp-content/uploads/2014/06/Final-report_Economic-Impact-of-Myasthenia-Gravis-08112013.pdf
Twork S, Wiesmeth S, Klewer J, Pöhlau D, Kugler J. Quality of life and life circumstances in German myasthenia gravis patients. Health Qual Life Outcomes. 2010;8:129.
Ruiter A, Verschuuren J, Tannemaat M. Fatigue in patients with myasthenia gravis. A systematic review of the literature. Neuromuscular Disorders. 2020;30(8):631-639.
Stewart SB, Roberston KR, Johnson KM, Howard JF Jr. The prevalence of depression in myasthenia gravis. J Clin Neuromusc Dis. 2007;8(3):111-115.
Harris L, Aban IB, Xin H, Cutter G. Employment in refractory myasthenia gravis: A Myasthenia Gravis Foundation of America Registry analysis. Muscle Nerve. 2019;60(6):700-706.
Mantegazza R, Antozzi C. When myasthenia gravis is deemed refractory: clinical signposts and treatment strategies. Ther Adv Neurol Disord. 2018;11:1756285617749134.
Gilhus NE. Myasthenia gravis. N Engl J Med. 2016;375(26):2570-2581.
Farmakidis C, Pasnoor M, Dimachkie MM, Barohn RJ. Treatment of myasthenia gravis. Neurol Clin. 2018;36(2):311-337.
Bacci ED, Coyne KS, Poon JL, Harris L, Boscoe AN. Understanding side effects of therapy for myasthenia gravis and their impact on daily life. BMC Neurol. 2019;19(1):335.