Suraj Muley, MD, FAAN, FACP

Articles by Suraj Muley, MD, FAAN, FACP

The discussion explores the evolving management of myasthenia gravis (MG), focusing on treatment selection, sequencing, and strategies for switching therapies in clinical practice. The expert faculty highlight how the expanding range of targeted therapies, including FcRn inhibitors, complement inhibitors, and B-cell–depleting agents, has enabled more individualized, patient-centered care, balancing short-term symptom control with long-term disease management. The panelists emphasize a shift toward earlier, proactive optimization of therapy to improve long-term outcomes and reduce disease burden in patients with MG.

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The discussion explores the evolving management of myasthenia gravis (MG), focusing on treatment selection, sequencing, and strategies for switching therapies in clinical practice. The expert faculty highlight how the expanding range of targeted therapies, including FcRn inhibitors, complement inhibitors, and B-cell–depleting agents, has enabled more individualized, patient-centered care, balancing short-term symptom control with long-term disease management. The panelists emphasize a shift toward earlier, proactive optimization of therapy to improve long-term outcomes and reduce disease burden in patients with MG.

Panelists discuss how investigational agents, including the complement inhibitor riliprubart, FcRn inhibitors like nipocalimab, batoclimab, and rozanolixizumab, as well as Bruton tyrosine kinase (BTK) inhibitors and anti–myelin-associated glycoprotein (anti-MAG) antibodies, show promise in providing targeted, personalized treatment options for patients with chronic inflammatory demyelinating polyneuropathy (CIDP) who are refractory to traditional therapies, with ongoing research needed to confirm their efficacy and safety.

Panelists discuss how variable number tandem repeats (VNTR) 3/2 polymorphisms in the FCGRT gene may affect FcRn levels, immunoglobulin G (IgG) half-life, and the effectiveness of intravenous immunoglobulin (IVIg) therapy in chronic inflammatory demyelinating polyneuropathy (CIDP), highlighting early real-world evidence suggesting that genetic testing could help personalize treatment strategies to optimize outcomes for patients based on their specific genotypes.

Panelists discuss how biomarkers, such as neurofilament light chain (NfL), autoantibodies, and inflammatory markers, have potential in enhancing chronic inflammatory demyelinating polyneuropathy (CIDP) diagnosis and treatment monitoring, but emphasize that their use remains experimental, and a comprehensive approach integrating clinical assessments and electrophysiological findings is essential for optimal patient care.

Panelists discuss how treatment options for patients with chronic inflammatory demyelinating polyneuropathy (CIDP) who do not respond to intravenous immunoglobulin (IVIg) or subcutaneous immunoglobulin (SCIg) include second-line therapies such as plasmapheresis, corticosteroids, immunosuppressive agents, and newer options like efgartigimod, with a focus on a tailored approach to manage refractory cases effectively and improve patient outcomes.

Panelists discuss how evaluating the efficacy of treatment in chronic inflammatory demyelinating polyneuropathy (CIDP) involves a combination of clinical, functional, and electrophysiological measures, and emphasize the importance of individualizing treatment approaches based on disease subtype, prior therapy response, comorbidities, patient preferences, and ongoing monitoring to optimize patient outcomes.

Panelists discuss how clinical experience with efgartigimod, a newly FDA-approved treatment for chronic inflammatory demyelinating polyneuropathy (CIDP), demonstrates positive outcomes and a favorable safety profile, while also addressing challenges in transitioning patients from other therapies and emphasizing the importance of proper patient selection and monitoring.

Panelists discuss how a recent study highlights concerns about transitioning patients with chronic inflammatory demyelinating polyneuropathy (CIDP) from intravenous immunoglobulin (IVIg) to efgartigimod, emphasizing the need for a cautious, gradual approach, careful patient selection, and close monitoring to address issues like symptom exacerbation, delayed response, and safety risks.

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