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Myasthenia gravis: Historical achievements and the 'golden age' of clinical trials
- Source :
- Journal of the neurological sciences. 406
- Publication Year :
- 2019
-
Abstract
- Since the death of Chief Opechankanough >350 years ago, the myasthenia gravis (MG) community has gained extensive knowledge about MG and how to treat it. This review highlights key milestones in the history of treatment and discusses the current “golden age” of clinical trials. Although originally thought by many clinicians to be a disorder of hysteria and fluctuating weakness without observable cause, MG is one the most understood autoimmune neurologic disorders. However, studying it in clinical trials has been challenging due to the fluctuating nature of the medical condition which impacts MG clinical outcomes. Clinical trials must also account for the possibility of a placebo effect. Because MG is a rare incurable autoimmune disorder, it limits the number of potential patients available to participate in clinical trials. In the last 15 years, however, significant progress has been made with MG randomized clinical trials, resulting in a new drug (eculizumab) for physicians' treatment repertoire and an old technique (thymectomy) confirmed effective for MG. Some of the therapies (eg, thymectomy, corticosteroids, plasma exchange, and intravenous immunoglobulin [IVIg]) have survived the test of time. Others (eg, eculizumab and neonatal Fc receptor inhibitor) are novel and hold promise.
- Subjects :
- Weakness
Pediatrics
medicine.medical_specialty
medicine.medical_treatment
Placebo
Antibodies, Monoclonal, Humanized
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
law
Myasthenia Gravis
medicine
Humans
030212 general & internal medicine
Clinical Trials as Topic
Plasma Exchange
business.industry
Immunoglobulins, Intravenous
Hysteria
Eculizumab
medicine.disease
Thymectomy
Myasthenia gravis
Clinical trial
Complement Inactivating Agents
Neurology
Neurology (clinical)
medicine.symptom
business
030217 neurology & neurosurgery
medicine.drug
Subjects
Details
- ISSN :
- 18785883
- Volume :
- 406
- Database :
- OpenAIRE
- Journal :
- Journal of the neurological sciences
- Accession number :
- edsair.doi.dedup.....4cc0bb360eb99a521d028cbc7af42f1c