Abstract:
PURPOSE OF REVIEW:To provide an update on immunomodulating and immunosuppressive therapies in myasthenia gravis and highlight newly approved, or pending approval, therapies with new biologics. RECENT FINDINGS:Preoperative IVIg is not needed to prevent myasthenic crisis in stable myasthenia gravis patients scheduled for surgery under general anesthesia, based on controlled data. Rituximab, if initiated early in new-onset myasthenia gravis, can lead to faster and more sustained remission even without immunotherapies in 35% of patients at 2 years. Biomarkers determining the timing for follow-up infusions in Rituximab-responding AChR-positive patients are discussed. Most patients with MuSK-positive myasthenia gravis treated with Rituximab have sustained long-term remission with persistent reduction of IgG4 anti-MuSK antibodies. Eculizumb in the extension REGAIN study showed sustained long-term pharmacological remissions and reduced exacerbations. Three new biologic agents showed promising results in phase-II controlled myasthenia gravis trials: Zilucoplan, a subcutaneous macrocyclic peptide inhibiting complement C5; Efgartigimod, an IgG1-derived Fc fragment binding to neonatal FcRn receptor; and Rozanolixizumab, a high-affinity anti-FcRn monoclonal antibody. Finally, the safety of ongoing myasthenia gravis immunotherapies during COVID19 pandemic is discussed. SUMMARY:New biologics against B cells, complement and FcRn receptor, are bringing us closer to successful targeted immunotherapies in the chronic management of myasthenia gravis promising an exciting future for antibody-mediated neurological diseases.
journal_name
Curr Opin Neuroljournal_title
Current opinion in neurologyauthors
Dalakas MCdoi
10.1097/WCO.0000000000000858subject
Has Abstractpub_date
2020-10-01 00:00:00pages
545-552issue
5eissn
1350-7540issn
1473-6551journal_volume
33pub_type
杂志文章abstract::Deletion of the 1.5 Mb tract on chromosome 17p11.2-12 that is duplicated in Charcot-Marie-Tooth disease type 1A is commonly associated with hereditary neuropathy with liability to pressure palsies. The deletion, which originates from an unequal meiotic crossover involving two homologous repeats, causes underexpression...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/00019052-199610000-00006
更新日期:1996-10-01 00:00:00
abstract::In multifocal motor or sensorimotor neuropathy with persistent conduction block, most of the recent research has concerned treatment. Open trials show that intravenous immunoglobulin is effective, providing a rapid and often marked clinical improvement, accompanied by a significant reduction of conduction block in som...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/00019052-199510000-00006
更新日期:1995-10-01 00:00:00
abstract:PURPOSE OF REVIEW:To summarize why there are polarized opinions regarding the management of patients with asymptomatic carotid disease and whether it is possible to identify patients who might benefit from carotid interventions. RECENT FINDINGS:Carotid Revascularization Endarterectomy Versus Stenting Trial and Asympto...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0000000000000408
更新日期:2017-02-01 00:00:00
abstract::Chlamydia pneumoniae is a common respiratory pathogen that is now being implicated in a number of chronic diseases. That the organism can infect vascular endothelium, macrophages and smooth muscle cells suggests that it may play a role in many systemic diseases. The present review focuses on the possibility that the c...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/00019052-200106000-00015
更新日期:2001-06-01 00:00:00
abstract:PURPOSE OF REVIEW:In recent years, advances in the understanding of the regulatory mechanisms of the immune system has led to the development of new approaches for cancer treatment. Currently, immune checkpoint inhibitors are the first successful examples of this approach and several agents that target cytotoxic lympho...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0000000000000391
更新日期:2016-12-01 00:00:00
abstract::New functional imaging techniques, including positron emission tomography, transcranial magnetic stimulation and functional magnetic resonance imaging, promise to allow the noninvasive study of haemodynamic, metabolic and activation parameters during acute migraine attacks in humans. These techniques are currently bei...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/00019052-199906000-00003
更新日期:1999-06-01 00:00:00
abstract:PURPOSE OF REVIEW:To give an overview on topics of pupillary function selected according to their relevance in clinical neurology. Mainly publications of the last 3 years have been considered. RECENT FINDINGS:The discovery of photosensitive retinal ganglion cells not serving vision, but serving circadian rhythm and th...
journal_title:Current opinion in neurology
pub_type: 杂志文章
doi:10.1097/WCO.0b013e3282f39173
更新日期:2008-02-01 00:00:00
abstract::Subacute focal encephalitis of Rasmussen involves cortical inflammatory infiltration which may on occasion be bilateral. The presence of anti-Glu R3 antibodies in some patients suggests that an autoimmune process may be involved. Although a small number of patients respond transiently to immunoglobulins and the condit...
journal_title:Current opinion in neurology
pub_type: 杂志文章
doi:
更新日期:1996-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Gadolinium-enhancement depicts blood-brain barrier disruption associated with new inflammatory MRI lesions in multiple sclerosis (MS) and is widely used for diagnosis and therapeutic monitoring. However, earlier and more specific markers of inflammation are urgently needed. RECENT FINDINGS:Susceptibi...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0000000000000326
更新日期:2016-06-01 00:00:00
abstract::With respect to diverse clinical applications for muscle regeneration, this paper discusses the latest markers for identifying skeletal muscle precursor cells in regenerating muscle, the implications of alternative sources of myogenic precursor cells and putative stem cells, and the current status of administration of...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/00019052-199910000-00007
更新日期:1999-10-01 00:00:00
abstract::Various functional imaging modalities can be applied in acute ischaemic stroke to identify functionally impaired, but morphologically preserved tissue (i.e. the penumbra), and to distinguish it from irreversibly damaged tissue. Flow thresholds for irreversible tissue destruction resulting in functional impairment, as ...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/00019052-200102000-00011
更新日期:2001-02-01 00:00:00
abstract:PURPOSE OF REVIEW:The present review will outline neuroprotective and neurotoxic effects of central nervous system (CNS) infiltrating T cells during viral infections. Evidence demonstrating differential roles for antiviral effector and resident memory T-cell subsets in virologic control and immunopathology in the CNS w...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0000000000000825
更新日期:2020-06-01 00:00:00
abstract::Insight into the pathomechanisms of the benign positional vertigo syndromes has led to quick and effective treatment with positional manoeuvres. Our understanding of other causes of vertigo is progressing at a slower pace, but several recent findings regarding vestibular neuritis, vascular compression of the eighth ne...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/00019052-199802000-00002
更新日期:1998-02-01 00:00:00
abstract:PURPOSE OF REVIEW:The diagnosis of dementia rests on an improved knowledge and a better detection of early impairments, to which functional imaging can certainly contribute. RECENT FINDINGS:Progress has been observed at different levels. First, the understanding of different dementias has benefited from explorations o...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/00019052-200208000-00006
更新日期:2002-08-01 00:00:00
abstract:PURPOSE OF REVIEW:The development of successful myelin repair strategies depends on the detailed knowledge of the cellular and molecular processes underlying demyelination and remyelination in the central nervous system of animal models and in patients with multiple sclerosis (MS). Based on the complexity of the demyel...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0b013e3282fd1875
更新日期:2008-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Central nervous system infections are not uncommon in systemic vasculitides. Being vigilant of central nervous system infections as an alternative consideration, instead of systemic vasculitides per se, could prove to be lifesaving in certain circumstances. RECENT FINDINGS:Common pathogens, such as t...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0b013e3283013983
更新日期:2008-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Tension-type headache is the most common type of headache and, in its chronic form, one of the most neglected and difficult types of headache to treat. Recently published data will be reviewed. RECENT FINDINGS:The prevalence of frequent tension-type headache increased significantly from 1989 to 2001,...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/01.wco.0000227043.00824.a9
更新日期:2006-06-01 00:00:00
abstract::There is a spectrum of acute autonomic neuropathies. Acute panautonomic neuropathy (pandysautonomia), characterized by severe widespread sympathetic and parasympathetic failure, is at one extreme. Guillain-Barré syndrome is at the other end of the spectrum, where the brunt of the disorder falls on the somatic nervous ...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/00019052-199410000-00007
更新日期:1994-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Recent progress in serological screening for paraneoplastic autoantibodies and diagnostic imaging techniques to detect malignancies has resulted in a broadening of the concept of paraneoplastic neurologic syndromes through the characterization of nonclassical clinical features. The goal of this articl...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0b013e32834a87b7
更新日期:2011-10-01 00:00:00
abstract:PURPOSE OF REVIEW:This article will review the recent experience with West Nile virus encephalitis and myelitis. RECENT FINDINGS:In the summer of 2003, the majority of cases of West Nile virus infection in the United States were reported from the western states. The transmission of West Nile virus through blood transf...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/00019052-200406000-00016
更新日期:2004-06-01 00:00:00
abstract:PURPOSE OF REVIEW:This article reviews what is known about the health and well being of adults with cerebral palsy. It also addresses the factors known to affect the areas identified in the World Health Organization International Classification of Functioning model as being critical for optimal health and well being. ...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0b013e3282f6a499
更新日期:2008-04-01 00:00:00
abstract:PURPOSE OF REVIEW:The traditional focus of neurorehabilitaion has been on the patients' attention on their deficit, such that they should become aware of their problems and gain intentional control of compensatory strategies (descending approach). We review prism adaptation as one of the approaches that emphasize ascen...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0b013e328010924b
更新日期:2006-12-01 00:00:00
abstract:PURPOSE OF REVIEW:This is an update on skeletal muscle sodium channelopathies since knowledge in the field have dramatically increased in the past years. RECENT FINDING:The relationship between two phenotypes and SCN4A has been confirmed with additional cases that remain extremely rare: severe neonatal episodic laryng...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0000000000000238
更新日期:2015-10-01 00:00:00
abstract::Although theoretical reasons exist for believing that selegiline slows the progression of Parkinson's disease, this has not been shown in clinical trials. Selegiline improves the symptoms of Parkinson's disease, allowing the introduction of levodopa to be delayed in de-novo patients and, later, for levodopa to be used...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/00019052-199608000-00012
更新日期:1996-08-01 00:00:00
abstract::Since the first successful attempts in 1990, human embryonic tissue transplantation has attracted the attention of multiple investigators and clinicians as a serious candidate therapy for Parkinson's disease. Although over two hundred patients have undergone the procedure, multiple issues and questions remain unresolv...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/00019052-199808000-00010
更新日期:1998-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Precise localization of the epileptogenic zone is imperative for the success of resective surgery of drug-resistant epileptic patients. To decrease the number of surgical failures, clinical research has been focusing on finding new biomarkers. For the past decades, high-frequency oscillations (HFOs, 8...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0000000000000663
更新日期:2019-04-01 00:00:00
abstract:PURPOSE OF REVIEW:To provide an update on the major advances in inflammatory myopathies. RECENT FINDINGS:Polymyositis is an uncommon disorder that can be misdiagnosed when the old, and never validated, criteria of Bohan and Peter are used. New diagnostic criteria were recently introduced, in which the MHC/CD8 complex ...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/00019052-200410000-00006
更新日期:2004-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Longitudinal studies that use MRI scans performed over multiple time-points have been increasingly employed in the study of different neurological disorders, including degenerative dementia, multiple sclerosis, and epilepsy. RECENT FINDINGS:Although it is well established that increased rates of brai...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0b013e32830719d4
更新日期:2008-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Homonymous hemianopia is the commonest form of acquired homonymous visual field defect; the usual causes are stroke, head injury and intracranial tumours. This impairment can affect a variety of cognitive visual functions, including visual search, safe navigation through changing environments and read...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0b013e32831f1b2c
更新日期:2009-02-01 00:00:00
abstract:PURPOSE OF REVIEW:The aim of this review is to refer to recent arguments supporting the existence of specific propagation mechanisms associated with spreading of neuron injury in amyotrophic lateral sclerosis (ALS). RECENT FINDINGS:Misfolded ALS-linked protein accumulation can induce aggregation of their native equiva...
journal_title:Current opinion in neurology
pub_type: 杂志文章,评审
doi:10.1097/WCO.0000000000000239
更新日期:2015-10-01 00:00:00