Self-Assessment: Immune Mediated Peripheral Neuropathies | Paradigm Clashes: Debate & Exploration in Choosing Traditional vs Novel Immunotherapeutics for MG-Paradigm Clashes: Session recording

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Video Summary

In a comprehensive session on novel therapies for myasthenia gravis (MG), experts discussed various treatment strategies in a debate format. Dr. Benjamin Kleder from Cleveland Clinic emphasized the efficacy and affordability of traditional immunotherapies like corticosteroids and non-steroidal immunosuppressive treatments, such as mycophenolate and azathioprine. He argued that these therapies lead to remission in many patients, are well-tolerated, have a known side effect profile, and are affordable compared to novel agents. Dr. Amanda Guidon argued for minimizing traditional therapies due to their broad immunosuppressive nature, delayed benefit, and significant side effects, including infection risk and possible cancer associations. She highlighted the burden of steroid side effects and the challenges in managing them. Dr. Neelam Goyal then presented the case for expanding the use of novel immunotherapies, like complement inhibitors and FCRN antagonists, in various MG contexts, including ocular MG, thymoma-associated MG, and MG crisis, citing studies that support their efficacy and potential for rapid symptom control. Finally, Dr. Jason Heer questioned the cost-effectiveness of novel treatments, emphasizing the need for comparative effectiveness research and biomarker development to predict treatment responses amidst escalating drug prices. The session concluded with case discussions highlighting different therapeutic strategies for MG, reflecting the nuanced decision-making involved when treating this complex condition.

Keywords

myasthenia gravis

novel therapies

immunotherapies

corticosteroids

mycophenolate

azathioprine

side effects

complement inhibitors

FCRN antagonists

ocular MG

thymoma-associated MG

MG crisis

cost-effectiveness