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Like a Game of Chess, Every Move Matters: The Role of Antibodies in the Myasthenia Gravis Treatment Landscape
Overview
Symptoms and disease pathophysiology of myasthenia gravis (MG) vary considerably with each patient, and their individual preferences and priorities add to the need for individualized treatment of this autoimmune disease. Research in MG has grown substantially in recent years. New treatments have the potential of being both effective and well tolerated, addressing the trade-off of choosing either efficacy or tolerability when selecting treatments. Promising investigational treatments that may become available in the future may allow more patients than ever before to achieve an asymptomatic state, with the ultimate goal being to turn off abnormal antibody production.
Learning Objectives
After studying this article, you should be able to:
- Consider mechanisms of disease and actions of medication in treatment decisions for patients with generalized myasthenia gravis (gMG) (including immunoglobulin G [IgG] and acetylcholine receptor [AChR] antibodies, fragment crystallizable neonatal receptor [FcRn] modulation)
- Counsel patients on the changing landscape of gMG treatment
- Incorporate evidence on efficacy and safety into the process of tailoring appropriate therapies for patients with gMG, both with current treatments and as novel ones become available
Target Audience
Neurology, neuromuscular, neuroimmunology, and neuro-ophthalmology advanced care practitioners
From the Series: Like a Game of Chess, Every Move Matters: The Role of Antibodies in the Myasthenia Gravis Treatment Landscape|
To cite: Bril V, Silvestri NJ, Barnett-Tapia C. Like a game of chess, every move matters: the role of antibodies in the myasthenia gravis treatment landscape. Prim Care Companion CNS Disord. 2022;24(6):AR21018AH3C.
© Copyright 2022 Physicians Postgraduate Press, Inc.
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Support Statement
Supported by an educational grant from argenx.
Learning Objective
After completing this educational activity, you should be able to:
- Consider mechanisms of disease and actions of medication in treatment decisions for patients with generalized myasthenia gravis (gMG) (including immunoglobulin G [IgG] and acetylcholine receptor [AChR] antibodies, fragment crystallizable neonatal receptor [FcRn] modulation)
- Counsel patients on the changing landscape of gMG treatment
- Incorporate evidence on efficacy and safety into the process of tailoring appropriate therapies for patients with gMG, both with current treatments and as novel ones become available
Release, Review, and Expiration Dates
This CME activity was published in October 2022 and is eligible for AMA PRA Category 1 Credit™ through December 31, 2023. The latest review of this material was September 2022
Statement of Need and Purpose
Treatment of gMG is not one-size-fits-all because of patients’ varied symptoms and disease pathophysiology. Despite numerous available therapies, the current treatment landscape for gMG has left many patients with unmet efficacy needs and considerable side effect burden. Research in gMG has grown substantially in recent years. Clinicians need awareness of disease mechanisms and education on the efficacy and safety of current and emerging therapies to improve outcomes for patients with gMG. This activity was designed to meet the needs of participants in CME activities provided by the CME Institute of Physicians Postgraduate Press, Inc., who have requested information on myasthenia gravis.
Unlabeled and Investigational Usage
The faculty of this educational activity may include discussions of products or devices that are not currently labeled for use by the FDA. Faculty members have been advised to disclose to the audience any reference to an unlabeled or investigational use.
No endorsement of unapproved products or uses is made or implied by coverage of these products or uses.
Please refer to the official prescribing information for each product for discussion of approved indicators, contraindications and warnings.
Review Process
The faculty members agreed to provide a balanced and evidence-based presentation and discussed the topics and CME objectives during the planning sessions. The faculty’s submitted content was validated by CME Institute staff, and the activity was evaluated for accuracy, use of evidence, and fair balance by the Chair and a peer reviewer who is without conflict of interest.
The opinions expressed herein are those of the faculty and do not necessarily reflect the opinions of the CME provider and publisher or the commercial supporter
© Copyright 2022 Physicians Postgraduate Press, Inc.
Faculty Affiliation
Vera Bril, MD, FRCPC
Division of Neurology, University of Toronto and University Health Network
Nicholas J. Silvestri, MD, FAAN
University at Buffalo Jacobs School of Medicine and Biosciences, New York
Carolina Barnett-Tapia, MD, PhD
Division of Neurology, University of Toronto and University Health Network
Financial Disclosure
The CME Institute adheres to the Standards for Integrity and Independence in Accredited Continuing Education of the Accreditation Council for Continuing Medical Education (ACCME). Any individuals in a position to control the content of a continuing education activity, including faculty, content developers, reviewers, staff, and others, are required to disclose to learners the presence or absence of any relevant financial relationships with an ACCME-defined ineligible company within the preceding 24 months of the activity. The ACCME defines an “ineligible company” as one whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
The CME Institute has mitigated all relevant conflicts of interest prior to the commencement of the activity. None of the individuals involved in the content have relevant financial relationships with ineligible companies except the following:
Dr Brill has served as a consultant for argenx, Alexion, Alnylam, Ackea, Ionis, Immunovant, Sanofi, Roche, UCB, Momenta, CSL, Takeda, Octapharma, NovoNordisk, Grifols, Janssen; received grant/research support from argenx, Alexion, UCB, Takeda, CSL, Immunovant, Momenta, Ionis, and Pharnext; received honoraria from argenx, Alexion, Alnylam, Ackea, Immunovant, Momenta, Ionis, and Pharnext; and has served on speakers/advisory boards for argenx, Alexion, Alnylam, Ackea, Ionis, Immunovant, Sanofi, Roche, UCB, Momenta, CSL, Takeda, Octapharma, NovoNordisk, Grifols, and Janssen. Dr Silvestri has served as a consultant for argenx and on speakers/advisory boards for Alexion, argenx, Immunovant, UCB, and Strongbridge. Dr Barnett-Tapia has served as a consultant for argenx and Alexion; received grant/research support from the US Department of Defense, MGNet, Muscular Dystrophy Canada, and Grifols; served on the advisory board for Sanofi; is the primary developer of the Myasthenia Gravis Impairment Index (MGII) and may receive royalties in the future.
Accredited Provider Disclosure
Michael R. Page, PharmD, RPh
Independent Medical Director/Medical Writer
Plainsboro, New Jersey
Dr. Page is a consultant for BioCentric, Inc. and American Medical Communications, Inc.
None of the other planners, reviewers, and CME Institute staff for this educational activity have relevant financial relationships with ineligible companies to disclose. All relevant financial relationships have been mitigated.
Accreditation Statement
The CME Institute of Physicians Postgraduate Press, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Credit Designation
The CME Institute of Physicians Postgraduate Press, Inc., designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Note: The American Nurses Credentialing Center (ANCC) and the American Academy of Physician Assistants (AAPA) accept certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.
To obtain credit for this activity, study the material and complete the CME Posttest and Evaluation.
Available Credit
- 1.00 AMA PRA Category 1 Credit™
- 1.00 Participation