Successful treatment requires a skilled physician overseeing management. Not all treatments are effective or viable options for all effected persons. Treatment must be individualized. Overall health history, disease presentation and severity, age, access to treatment, clinical skill and patient choice will all factor into medication management.This information is meant strictly as a guide. Always consult with a physician before making any changes to your medication regimen.
Please note that pyridostigmine bromide may contain large amounts of lactase that can aggravate patients who are lactose intolerant or allergic and is cautioned in the use of patients with asthma due to a possible increase in bronchial secretions and in patients with mechanical, intestinal or urinary obstruction. Please work with your care provider in determining the best course of action for your individual needs.
Eculizumab (Soliris) is the first FDA approved treatment for Myasthenia Gravis in decades and one of only two FDA approved therapy options. It is also the latest treatment option in Myasthenia Gravis. This treatment works by binding to a particular protein that is involved in the immune system and subsequently inhibits one of the ways in which the immune system can attack the neuromuscular junction (where Myasthenia Gravis manifests). This is indicated for use with AChR antibody positive patients who have failed previous therapies to adequately control their MG symptoms and have a more severe presentation. The risk for serious infection is present and the patient's health history should be well screened before beginning this treatment.
Rituximab (Rituxan) is a chimaeric monoclonal antibody specific for human CD20 that targets B lymphocytes. Originally developed for B-cell lymphoma, Rituximab was noted in clinical studies to also show benefit in some autoimmune diseases. Myasthenia Gravis has shown a history of B-cell hyperactivation which is believed to be a driving force behind antibody production. Rituximab is a new line of targeted therapy theorized to help halt or prevent this hyperactivation. Currently studied for refractory and seronegative cases, Rituximab has shown great promise as an advancing therapy for Myasthenia Gravis. While many can tolerate it fairly well, it is an aggressive drug that comes with potentially serious risks and should be used with great caution and oversight by a skilled doctor who is experienced using Rituximab with Myasthenia Gravis.
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