Glucocorticoids remain the basis for treatment of myasthenia gravis in the era of targeted therapies

Abstract

Myasthenia gravis (MG) treatment has entered an era of targeted therapies. Different targeted therapies take effect in various aspects of pathogenic mechanisms in MG. For a steady long⁃term control of MG symptoms, immunotherapies that reduce the production of pathogenic autoantibodies should be used. The glucocorticosteroid acts on multiple aspects of pathogenic mechanisms relevant to autoantibody production and regulation of the immune network, which renders glucocorticosteroid the basis of MG therapy. A definite therapeutic target has been established in MG. Glucocorticosteroid can be used alone or in combination with traditional immunosuppressants or targeted therapies at different stages of the treat ⁃ to ⁃ target process. Based on the evaluation of the beneficial characteristics of patients using the traditional glucocorticosteroid escalation strategy, the implementation of the glucocorticosteroid ⁃based and treat⁃to⁃target⁃oriented individualized treatment helps to obtain better long⁃to⁃term efficacy.

DOI: 10.3969/j.issn.1672⁃6731.2024.05.001