Myasthenia gravis (MG) varies widely in presentation and severity, making it important for patients to have individualized goals for comprehensive care.
However, guidance on how to implement comprehensive care in patients with MG is limited.
A steering committee of three neurologists selected relevant topics, and the authors developed draft recommendations for each.
These global recommendations can guide comprehensive care, improving disease outcomes and quality of life for patients with MG.
However, the authors note that recommendations will need to be updated as treatments for MG are further developed.
Myasthenia gravis (MG) varies widely in presentation and severity, making it important for patients to have individualized goals for comprehensive care. However, guidance on how to implement comprehensive care in patients with MG is limited.
In a paper published in Neurology Clinical Practice, Pushpa Narayanaswami, MD, of Beth Israel Deaconess Medical Center/Harvard Medical School in Boston, Massachusetts, and colleagues presented global consensus recommendations for comprehensive care in MG. To create these recommendations, an international panel of 15 neurology experts was formed, and a targeted literature review was conducted. A steering committee of three neurologists selected relevant topics, and the authors developed draft recommendations for each.
Formal consensus was achieved using the RAND/UCLA appropriateness method, with panelists from across North America, Europe, and Asia rating statements on a scale of 1, meaning “extremely inappropriate,” to 9, meaning “extremely appropriate.” Panelists also offered suggestions for modification, followed by additional rounds of rating after the modifications were made. Over 20 statements achieved agreement as appropriate after 4 rounds of rating and were accepted.
The first statement to achieve consensus defined the ongoing treatment goal for patients with MG as “to work toward, achieve, and sustain minimal symptoms and treatment-related adverse events, with a patient-acceptable quality of life (using validated measures).” Other statements covered early symptom control, formation and maintenance of a treatment goal, infant vaccination and screening, family planning, management of comorbidities, and crisis management.
These global recommendations can guide comprehensive care, improving disease outcomes and quality of life for patients with MG. However, the authors note that recommendations will need to be updated as treatments for MG are further developed.
