Myasthenia Gravis

Overview

Myasthenia gravis (MG) is an autoimmune condition in which antibodies interfere with the signal between nerves and muscles. Most people have antibodies against the acetylcholine receptor (AChR); a smaller group has antibodies against MuSK. Weakness typically gets worse with activity and improves with rest. In generalized MG, it affects more than the eye muscles.

Common Signs and Symptoms

• Drooping eyelids or double vision
• Slurred or nasal-sounding speech
• Trouble chewing or swallowing
• Weakness in the arms, legs or neck
• Shortness of breath

When to Contact a Provider

See a provider about new eyelid drooping, double vision or weakness that changes through the day. Trouble breathing or swallowing can signal a myasthenic crisis and is an emergency.

How Treatment May Help

Treatment may include pyridostigmine, steroids or other immune-suppressing medicines, and for some people surgery to remove the thymus. For generalized MG with specific antibodies, a neurologist may prescribe a targeted therapy, which may help reduce symptoms and improve daily function. Plasma exchange or immune globulin may be used for serious flares.

Therapies That May Be Available at Infuse Care

• Vyvgart (efgartigimod alfa): IV infusion, once a week for four weeks per treatment cycle; for adults with AChR antibody-positive generalized MG
• Ultomiris (ravulizumab): IV infusion; a starting dose, then every eight weeks; for adults with AChR antibody-positive generalized MG
• Rystiggo (rozanolixizumab): subcutaneous infusion (under the skin, with a pump), once a week in six-week cycles; for adults with AChR or MuSK antibody-positive generalized MG

Safety and Monitoring

Ultomiris carries a boxed warning for serious meningococcal infections. Meningococcal vaccines are required, ideally at least two weeks before the first dose, and it is available only through a safety program. Seek care right away for fever, headache with a stiff neck, or a rash.

Vyvgart and Rystiggo may raise the risk of infections, and headache is common. Infusion reactions can occur, so you are monitored during treatment.

Your prescribing provider decides which treatment is right for you. Infuse Care administers prescribed therapies after a referral, a clinical review and any required insurance authorization, and we keep your provider's office updated on your care.