How is MG Treated?

There is no known cure for MG but there are effective treatments that allow many people with MG to lead full lives. Neurologists work with their patients to develop individualized treatment plans tailored to the severity of the disease which may include some or all of the following:

  1. Cholinesterase inhibitors - these are anticholinesterase medications which boost the neuromuscular transmission by blocking the enzyme responsible for breaking down acetylcholine.   They include Mestinon (pyridostigmine bromide), Prostigmin (neostigmine bromide) and Mytelase (ambenonium chloride).  While safe and rapidly-acting, these medications have no effect on the ongoing destruction of the acetylcholine receptors caused by the immune response.
  2. Plasmapheresis - This is a short-term treatment whereby abnormal antibodies are removed from the patient’s blood and the red blood cells are then returned in artificial plasma.
  3. Intravenous human immune globulin (IVIG) - Roughly thought of as the opposite of plasmapheresis, IVIG is thought to have a non-specific suppressive effect upon the immune system. IVIG overwhelms the body with antibodies that are pooled from many donors.
  4. Thymectomy - While tumors of the thymus gland (thymomas) are found in 15% of MG patients, for most myasthenics the thymus gland is abnormal but there is no tumor.  Surgical removal of the thymus gland offers the possibility of recovery from MG leading to an eventual symptom-free and drug-free remission.
  5. Immunosuppressive Drugs - A group of drugs, the presumed action of which is to suppress the body’s immune system, are used to treat MG. They include:
    • Prednisone is a synthetic steroid drug which may initially make MG worse, it is considered to be generally effective in eventually reversing MG symptoms. Since prednisone has a great many potentially undesirable side effects such as weight gain, diabetes and hypertension, it requires careful monitoring.
    • Azathioprine (brand name Imuran) may be used to decrease the dosage of prednisone needed to maintain long-term remission and reduce the risk of side effects. Azathioprine may also be taken alone in patients who cannot tolerate or do not respond to prednisone. It may take several months of treatment to achieve an adequate response from this drug.
    • Mycophenolate mofetil (brand name Cellcept) is advocated for the treatment of MG as an immunosuppressive alternative for azathioprine. It is supposed to work more quickly than azathioprine and with fewer side effects.
    • Cyclophosphamide (brand name Cytoxan) and cyclosporine (brand name Sandimmune and Neoral) are medications considered to be effective therapies for the most severe cases of MG.  The use of these drugs is limited by their adverse side effects.

Please Note The Myasthenia Gravis Foundation of California does not provide medical advice.  The contents of this website are for information purposes only and are not intended as a substitute for professional medical advice.  Your physician should be your primary source of medical care for your MG.

 

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