Current and future therapeutic options for the treatment of the generalized form of myasthenia gravis

Myasthenia gravis is a rare chronic autoimmune disease affecting the neuromuscular junction. Basic therapeutic procedures include lifestyle regimen, cholinesterase inhibitor symptomatic and immunomodulatory treatment, and thymectomy in indicated cases. We can influence myasthenia gravis immunopathogenesis acutely with plasmapheresis or intravenous immunoglobulins or orally with long-term corticoid and/ or immunosuppressive treatment. In recent years, various biological treatments have been expanding, including C5 complement inhibitors and blockers of neonatal Fc receptors. First approved in the Czech Republic are eculizumab and efgartigimod. Eculizumab is indicated for seropositive refractory generalized myasthenia gravis. Efgartigimod is approved as add on therapy for the standard treatment of adult patients with generalized myasthenia gravis who are positive for antibodies against the acetylcholine receptor.