Biological therapies for myasthenia gravis

ABSTRACT

Introduction

Recently, treatments for myasthenia gravis (MG) have progressed significantly. Symptoms of some patients with refractory MG are not relieved by conventional therapies, and such patients might benefit from novel biological treatments that are being developed.

Areas covered

We review several novel biological therapies for MG, such as complement inhibitors, neonatal Fc receptor inhibitors, anti-B cell drugs, and IL-6 receptor inhibitors. We also report the modes of action, efficacy, safety, and tolerability of these drugs.

Expert opinion

Several biological therapies have been developed for MG, and these biologics are promising agents for treating refractory MG. Establishing biomarkers and accumulating evidence of therapeutic response is required to provide the most appropriate biological treatment for each patient.

KEYWORDS:

• anti-B cell drug
• biological drug
• complement inhibitors
• IL-6 receptor inhibitor
• neonatal Fc receptor inhibitor
• refractory

Article highlights

• It has often been difficult to achieve sustained remission in myasthenia gravis (MG).

• Treatments for MG have progressed significantly in recent years.

• Symptoms of some patients with refractory MG are not relieved by conventional therapies, and such patients might benefit from novel biological treatments that are being developed.

• The modes of action, efficacy, safety, and tolerability of several novel biological therapies for MG, such as complement inhibitors, neonatal Fc receptor inhibitors, anti-B cell drugs, and IL-6 receptor inhibitors are introduced.

• Establishing biomarkers and accumulating evidence of therapeutic responses is required to provide the most appropriate biological treatment for each patient.

Declaration of interest

A Uzawa has received honoraria from Alexion Pharmaceuticals and Argenx. K. Utsugisawa has served as a paid Consultant for UCB Pharma, Janssen Pharma, Horizon Therpeutics (Viela Bio), Chugai Pharma, Hanall BioPharma, and Mitsubishi Tanabe Pharma, and has received speaker honoraria from Argenx, Alexion Pharmaceuticals, UCB Pharma, and the Japan Blood Products Organization. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was funded in part by the Health and Labour Sciences Research Grant on Intractable Diseases (Neuroimmunological Diseases) from the Ministry of Health, Labour, and Welfare of Japan (Grant number: 20FC1030).