International consensus guidance for management of myasthenia gravis: Executive summary

Donald B. Sanders, Gil I. Wolfe, Michael Benatar, Amelia Evoli, Nils E. Gilhus, Isabel Illa, Nancy Kuntz, Janice M. Massey, Arthur Melms, Hiroyuki Murai, Michael Nicolle, Jacqueline Palace, David P Richman, Jan Verschuuren, Pushpa Narayanaswami

Research output: Contribution to journalReview article

249 Scopus citations

Abstract

Objective: To develop formal consensus-based guidance for the management of myasthenia gravis (MG). Methods: In October 2013, the Myasthenia Gravis Foundation of America appointed a Task Force to develop treatment guidance for MG, and a panel of 15 international experts was convened. The RAND/UCLA appropriateness methodology was used to develop consensus guidance statements. Definitions were developed for goals of treatment, minimal manifestations, remission, ocular MG, impending crisis, crisis, and refractory MG. An in-person panel meeting then determined 7 treatment topics to be addressed. Initial guidance statements were developed from literature summaries. Three rounds of anonymous e-mail votes were used to attain consensus on guidance statements modified on the basis of panel input. Results: Guidance statements were developed for symptomatic and immunosuppressive treatments, IV immunoglobulin and plasma exchange, management of impending and manifest myasthenic crisis, thymectomy, juvenile MG, MG associated with antibodies to muscle-specific tyrosine kinase, and MG in pregnancy. Conclusion: This is an international formal consensus of MG experts intended to be a guide for clinicians caring for patients with MG worldwide.

Original languageEnglish (US)
Pages (from-to)419-425
Number of pages7
JournalNeurology
Volume87
Issue number4
DOIs
StatePublished - Jul 26 2016

ASJC Scopus subject areas

  • Medicine(all)
  • Clinical Neurology

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