Novel Immunotherapies for Myasthenia Gravis

Sruthi S Nair,1,2 Saiju Jacob1,3 1Department of Neurology, University Hospitals Birmingham, Birmingham, B15 2TH, UK; 2Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India; 3Institute of Immunology and Immunotherapy, University...

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Main Authors: Nair SS, Jacob S
Format: Article
Language:English
Published: Dove Medical Press 2023-04-01
Series:ImmunoTargets and Therapy
Subjects:
Online Access:https://www.dovepress.com/novel-immunotherapies-for-myasthenia-gravis-peer-reviewed-fulltext-article-ITT
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author Nair SS
Jacob S
author_facet Nair SS
Jacob S
author_sort Nair SS
collection DOAJ
description Sruthi S Nair,1,2 Saiju Jacob1,3 1Department of Neurology, University Hospitals Birmingham, Birmingham, B15 2TH, UK; 2Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India; 3Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, UKCorrespondence: Saiju Jacob, Consultant Neurologist, University Hospitals Birmingham, Edgbaston, Birmingham, B15 2TH, United Kingdom, Tel +44 0121 3716844, Fax +44 0121 4605300, Email s.jacob@bham.ac.ukAbstract: Myasthenia gravis (MG), a prototype autoimmune neurological disease, had its therapy centred on corticosteroids, non-steroidal broad-spectrum immunotherapy and cholinesterase inhibitors for several decades. Treatment-refractory MG and long-term toxicities of the medications have been major concerns with the conventional therapies. Advances in the immunology and pathogenesis of MG have ushered in an era of newer therapies which are more specific and efficacious. Complement inhibitors and neonatal Fc receptor blockers target disease-specific pathogenic mechanisms linked to myasthenia and have proven their efficacy in pivotal clinical studies. B cell-depleting agents, specifically rituximab, have also emerged as useful for the treatment of severe MG. Many more biologicals are in the pipeline and in diverse stages of development. This review discusses the evidence for the novel therapies and the specific issues related to their clinical use.Keywords: myasthenia gravis, refractory myasthenia gravis, complement inhibitors, FcRn blocker, B cell depletion
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spelling doaj.art-81ea017d2fa041a28d30a812e4eb54952023-04-04T20:11:34ZengDove Medical PressImmunoTargets and Therapy2253-15562023-04-01Volume 12254582783Novel Immunotherapies for Myasthenia GravisNair SSJacob SSruthi S Nair,1,2 Saiju Jacob1,3 1Department of Neurology, University Hospitals Birmingham, Birmingham, B15 2TH, UK; 2Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India; 3Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, UKCorrespondence: Saiju Jacob, Consultant Neurologist, University Hospitals Birmingham, Edgbaston, Birmingham, B15 2TH, United Kingdom, Tel +44 0121 3716844, Fax +44 0121 4605300, Email s.jacob@bham.ac.ukAbstract: Myasthenia gravis (MG), a prototype autoimmune neurological disease, had its therapy centred on corticosteroids, non-steroidal broad-spectrum immunotherapy and cholinesterase inhibitors for several decades. Treatment-refractory MG and long-term toxicities of the medications have been major concerns with the conventional therapies. Advances in the immunology and pathogenesis of MG have ushered in an era of newer therapies which are more specific and efficacious. Complement inhibitors and neonatal Fc receptor blockers target disease-specific pathogenic mechanisms linked to myasthenia and have proven their efficacy in pivotal clinical studies. B cell-depleting agents, specifically rituximab, have also emerged as useful for the treatment of severe MG. Many more biologicals are in the pipeline and in diverse stages of development. This review discusses the evidence for the novel therapies and the specific issues related to their clinical use.Keywords: myasthenia gravis, refractory myasthenia gravis, complement inhibitors, FcRn blocker, B cell depletionhttps://www.dovepress.com/novel-immunotherapies-for-myasthenia-gravis-peer-reviewed-fulltext-article-ITTmyasthenia gravisrefractory myasthenia graviscomplement inhibitorsfcrn blockerb cell depletion
spellingShingle Nair SS
Jacob S
Novel Immunotherapies for Myasthenia Gravis
ImmunoTargets and Therapy
myasthenia gravis
refractory myasthenia gravis
complement inhibitors
fcrn blocker
b cell depletion
title Novel Immunotherapies for Myasthenia Gravis
title_full Novel Immunotherapies for Myasthenia Gravis
title_fullStr Novel Immunotherapies for Myasthenia Gravis
title_full_unstemmed Novel Immunotherapies for Myasthenia Gravis
title_short Novel Immunotherapies for Myasthenia Gravis
title_sort novel immunotherapies for myasthenia gravis
topic myasthenia gravis
refractory myasthenia gravis
complement inhibitors
fcrn blocker
b cell depletion
url https://www.dovepress.com/novel-immunotherapies-for-myasthenia-gravis-peer-reviewed-fulltext-article-ITT
work_keys_str_mv AT nairss novelimmunotherapiesformyastheniagravis
AT jacobs novelimmunotherapiesformyastheniagravis