Observational studyAnnals of clinical and translational neurology2022
Drug-refractory myasthenia gravis: Clinical characteristics, treatments, and outcome.
Observational study in Annals of clinical and translational neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 53 citations in OpenAlex.
- Double-seronegative myasthenia gravis: clinical characteristics, treatment, and outcomes - a systematic review of case reports and case series.BMC neurology · 2026Pooled it
- Initiation response, maximized therapeutic efficacy, and post-treatment effects of biological targeted therapies in myasthenia gravis: a systematic review and network meta-analysis.Frontiers in neurology · 2024Pooled it
- Chimeric Antigen Receptor T-Cell Therapy in Autoimmune Disorders: An Expert Panel Opinion From the American Society for Transplantation and Cellular Therapy.Transplantation and cellular therapy · 2026Review
- Treatment Patterns and Outcomes of Anti-MuSK Antibody-Positive Myasthenia Gravis: A Retrospective Single-Center Study.Journal of Korean medical science · 2026Article
- Assessing the Value Contribution of VyvgartAdvances in therapy · 2026Article
- CAR T cell therapy in autoantibody-mediated neurological disorders: a promising strategy.Journal of neuroinflammation · 2026Review
- Early versus late add-on therapy in generalized myasthenia gravis: a multicenter real-world cohort study.Journal of neurology · 2026Observational
- Targeting pathogenic Th17.1 cells via JAK-STAT3 pathway: A novel approach with tofacitinib for refractory myasthenia gravis.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2026Article
- Article
- Case Report: Efgartigimod: a beacon of hope for overlapping stiff-person syndrome and myasthenia gravis following thymoma.Frontiers in immunology · 2026Article
- Unknown Immunoregulatory Effects of FcRn Inhibition by Efgartigimod in Myasthenia Gravis: A New Mechanism of Action Beyond IgG Reduction.Neurology(R) neuroimmunology & neuroinflammation · 2025Article
- Early prediction of refractory myasthenia gravis based on response to treatment within the first year of diagnosis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Article
- Myasthenia gravis in 2025: five new things and four hopes for the future.Journal of neurology · 2025Review
- Refractory myasthenia gravis treated with autologous hematopoietic stem cell transplantation.Annals of clinical and translational neurology · 2025Article
- Rituximab for refractory ocular symptoms in myasthenia gravis with thyroid eye disease: a case report with quantitative MRI assessment.Frontiers in immunology · 2025Article
- Persistent symptoms, exacerbations and drug side effects despite treatment in myasthenia gravis.European journal of neurology · 2025Article
- Patterns and predictors of therapeutic response to efgartigimod in acetylcholine receptor-antibody generalized myasthenia gravis subtypes.Therapeutic advances in neurological disorders · 2025Article
- Diagnostic value of antibody concentration ratio for treatment-refractory myasthenia gravis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024Article
- Drug Use Patterns in Myasthenia Gravis: A Real-World Population-Based Cohort Study in Italy.Journal of clinical medicine · 2024Article
- A predictive nomogram for short-term outcomes of myasthenia gravis patients treated with low-dose rituximab.CNS neuroscience & therapeutics · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
25 authors at 13 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo describe the clinical characteristics and outcomes in patients with refractory myasthenia gravis (MG) and to determine the effectiveness and side effects of the drugs used for their treatment.
methodsThis observational retrospective cross-sectional multicenter study was based on data from the Spanish MG Registry (NMD-ES). Patients were considered refractory when their MG Foundation of America post-interventional status (MGFA-PIS) was unchanged or worse after corticosteroids and two or more other immunosuppressive agents. Clinical and immunologic characteristics of drug-refractory patients, efficiency and toxicity of drugs used, and outcome (MGFA-PIS) at end of follow-up were studied.
resultsWe included 990 patients from 15 hospitals. Eighty-four patients (68 of 842 anti-acetylcholine receptor [AChR], 5 of 26 anti-muscle-specific tyrosine kinase [MusK], 10 of 120 seronegative, and 1 of 2 double-seropositive patients) were drug refractory. Drug-refractory patients were more frequently women (p < 0.0001), younger at onset (p < 0.0001), and anti-MuSK positive (p = 0.037). Moreover, they more frequently presented a generalized form of the disease, bulbar symptoms, and life-threatening events (p < 0.0001; p = 0.018; and p = 0.002, respectively) than non-drug-refractory patients. Mean follow-up was 9.8 years (SD 4.5). Twenty-four (50%) refractory patients had side effects to one or more of the drugs. At the end of follow-up, 42.9% of drug-refractory patients (42.6% of anti-AChR, 100% of anti-MuSK, and 10% of seronegative patients) and 79.8% of non-drug-refractory patients (p < 0.0001) achieved remission or had minimal manifestations. Eighty percent of drug-refractory-seronegative patients did not respond to any drug tested.
interpretationIn this study, 8.5% of MG patients were drug-refractory. New more specific drugs are needed to treat drug-refractory MG patients.
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