Switching MG Treatment Due to Adverse Events or Poor Disease Control

Opinion
Video

Expert neurologists share approaches to switching MG treatment due to either poor disease control or adverse events.

This is a video synopsis/summary of a panel discussion involving James Howard, MD; Nicholas Silvestri, MD, FAAN; Tuan Vu, MD; Ali Habib, MD; and Beth Stein, MD.

The transcript discusses 2 patient scenarios regarding treatment options for neurological diseases. In the first case, a patient experiences poor disease control and adverse reactions to prior treatments, including diarrhea, abdominal cramping, and hyperhidrosis. The panel discusses the possibility of adjusting the dosage of the current medication, pyridostigmine, and considers switching to an alternative treatment due to infections associated with eculizumab.

In the second scenario, a middle-aged patient with a long history of acetylcholine receptor (AChR) generalized disease has had a poor response to several standard-of-care treatments, including corticosteroids and intravenous immunoglobulin. The panel deliberates on whether to opt for an neonatal crystallizable fragment receptor (FcRn) antagonist or a complement inhibitor as the next course of action, considering the patient's unresponsiveness to previous therapies.

There's a discussion about the importance of evaluating the patient's treatment history, ensuring correct dosages, and considering potential comorbidities or untreated illnesses that may affect treatment response. The challenges faced by community neurologists in managing cytotoxic therapies due to limited experience and resources are also acknowledged.

Video synopsis is AI-generated and reviewed by NeurologyLive editorial staff.

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