International consensus guidance for management of myasthenia gravis: Executive summary.


Journal Article (Review)

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.

Full Text

Duke Authors

Cited Authors

  • Sanders, DB; Wolfe, GI; Benatar, M; Evoli, A; Gilhus, NE; Illa, I; Kuntz, N; Massey, JM; Melms, A; Murai, H; Nicolle, M; Palace, J; Richman, DP; Verschuuren, J; Narayanaswami, P

Published Date

  • July 26, 2016

Published In

Volume / Issue

  • 87 / 4

Start / End Page

  • 419 - 425

PubMed ID

  • 27358333

Pubmed Central ID

  • 27358333

Electronic International Standard Serial Number (EISSN)

  • 1526-632X

Digital Object Identifier (DOI)

  • 10.1212/WNL.0000000000002790


  • eng

Conference Location

  • United States