Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Neuromuscular disease

Advances in the therapeutic algorithm for myasthenia gravis

Nature Reviews Neurology volume 19, pages 393–394 (2023)Cite this article

Subjects

New biologics are rapidly opening up target-specific therapeutic opportunities for myasthenia gravis (MG) — an autoimmune disease caused by antibodies against neuromuscular junction proteins. Two recent trials have now demonstrated the efficacy and tolerability of the complement C5 inhibitor zilucoplan and the FcRn inhibitor rozanolixizumab in patients with generalized MG.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Dalakas, M. C. Immunotherapy in myasthenia gravis in the era of biologics. Nat. Rev. Neurol. 15, 113–124 (2019).

    Article  PubMed  Google Scholar 

  2. Dalakas, M. C. Progress in the therapy of myasthenia gravis: getting closer to effective targeted immunotherapies. Curr. Opin. Neurol. 33, 545–552 (2020).

    Article  CAS  PubMed  Google Scholar 

  3. Dalakas, M. C. Role of complement, anti-complement therapeutics, and other targeted immunotherapies in myasthenia gravis. Expert Rev. Clin. Immunol. 18, 691–701 (2022).

    Article  CAS  PubMed  Google Scholar 

  4. Howard, J. F. Jr et al. Safety and efficacy of zilucoplan in patients with generalised myasthenia gravis (RAISE): a randomised, double-blind, placebo-controlled, phase 3 study. Lancet Neurol. 22, 395–406 (2023).

    Article  CAS  PubMed  Google Scholar 

  5. Bril, V. et al. Safety and efficacy of rozanolixizumab in patients with generalised myasthenia gravis (MycarinG): a randomised, double-blind, placebo-controlled, adaptive phase 3 study. Lancet Neurol. 22, 383–394 (2023).

    Article  CAS  PubMed  Google Scholar 

  6. Dalakas, M. C. IgG4-mediated neurological autoimmunities: understanding the pathogenicity of IgG4, ineffectiveness of IVIg and long-lasting benefits of anti-B cell therapies. Neurol. Neuroimmunol. Neuroinflamm. 9, e1116 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  7. Bril, V. et al. Long-term efficacy and safety of symptom-driven cyclical rozanolixizumab treatment in patients with generalized myasthenia gravis: a pooled analysis of a Phase 3 study and two open-label extension studies. Neurology https://doi.org/10.1212/WNL.0000000000203497 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  8. Freimer, M. et al. RAISE-XT: An interim analysis of safety and efficacy in an open-label extension of zilucoplan in patients with myasthenia gravis. Neurology https://doi.org/10.1212/WNL.0000000000202910 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  9. Stathopoulos, P. & Dalakas, M. C. Evolution of anti-B cell therapeutics in autoimmune neurological diseases. Neurotherapeutics 19, 691–710 (2022).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Brauner, S. et al. Comparison between rituximab treatment for new-onset generalized myasthenia gravis and refractory generalized myasthenia gravis. JAMA Neurol. 77, 974–981 (2020).

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA

    Marinos C. Dalakas

  2. Neuroimmunology Unit, National and Kapodistrian University, University of Athens Medical School, Athens, Greece

    Marinos C. Dalakas

Authors
  1. Marinos C. Dalakas
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marinos C. Dalakas.

Ethics declarations

Competing interests

The author declares no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dalakas, M.C. Advances in the therapeutic algorithm for myasthenia gravis. Nat Rev Neurol 19, 393–394 (2023). https://doi.org/10.1038/s41582-023-00825-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41582-023-00825-y

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing