Sequence of Standard Treatment Protocol
Below is a sequence of standard treatment protocols care providers may implement to treat MG. Please note that this is not a fixed sequence. Treatment plans are determined based on multiple factors including severity, type of MG, response to treatment, and other elements that need consideration before implementation.
First-Line Treatments & Therapies
Pyridostigmine | Mestinon
Pyridostigmine, commonly known as Mestinon, is in a class of medications called Cholinergic muscle stimulants. This medication is primarily used to treat myasthenia gravis, a condition that causes muscle weakness.
Thymectomy
A thymectomy is a surgery to take out your thymus gland and thymic tumors. It’s in your upper chest in front of your heart.
Second-Line Treatments & Therapies
Azathioprine
Azathioprine is in a class of medications called immunosuppressants. It works by decreasing the activity of the body's immune system so it will not attack the transplanted organ or the joints.
Cyclosporine
Cyclosporine is in a class of medications called immunosuppressants. They work by decreasing the activity of the immune system.
Intravenous Immune Globulin
Intravenous immune globulin, commonly referred to IVIG, is in a class of medications called immune globulins. It works by providing antibodies to fight infections and to manage other conditions.
Rituximab
Rituximab injection products are in a class of medications called monoclonal antibodies. It is used as a second-line treatment for individuals diagnoses with MuSK+ myasthenia gravis.
Tacrolimus
Tacrolimus is in a class of medications called immunosuppressants. It works by decreasing the activity of the immune system to prevent it from attacking the transplanted organ.
Third-Line Treatments & Therapies
Eculizumab | Soliris
Eculizumab injection, also known as Soliris, works by blocking the activity of the part of the immune system by disrupting communication between nerves and muscles in people with MG.
Efgartigimod | Vyvgart
Efgartigimod alfa-fcab, also known as Vyvgart, is in a group of medications called monoclonal antibodies. It works by reducing a certain natural substance in the body that causes symptoms of myasthenia gravis.
Efgartigimod + Hyaluronidase-qvfc | Vyvgart Hytrulo
Efgartigimod alfa-fcab, also known as Vyvgart Hytrulo, is in a group of medications called monoclonal antibodies. It works by reducing a certain natural substance in the body that causes symptoms of myasthenia gravis and chronic inflammatory demyelinating polyneuropathy. Hyaluronidase-qvfc is an endoglycosidase. It helps to keep efgartigimod alfa in the body longer so that the medication will have a greater effect.
Methotrexate
Methotrexate is in a class of medications called antimetabolites. Methotrexate works by decreasing the activity of the immune system.
Mycophenolate Motefi
Mycophenolate belongs to a group of medicines known as immunosuppressive agents. It is used to lower the body's natural immunity.
Nipocalimab-aahu | IMAAVY
Nipocalimab-aahu injection, also known as IMAAVY, is in a group of medications called monoclonal antibodies. It works by reducing a certain natural substance in the body that causes symptoms of myasthenia gravis.
Plasmapheresis | PLEX
Plasmapheresis, also known as PLEX, is the process healthcare providers use to obtain plasma from blood. The process involves using a machine to separate plasma from blood and then returning the blood to the person receiving treatment.
Ravulizumab | Ultomiris
Ravulizumab, also known as Ultomiris, is in a class of medications called monoclonal antibodies. It works by disrupting communication between nerves and muscles in people with MG.
Rozanolixizumab-noli | Rystiggo
Rozanolixizumab, also known as Rystiggo, is in a class of medications called Fc receptor blockers. It works by reducing the amount of IgG (an antibody that attacks neuromuscular receptors in patients with myasthenia gravis) circulating in the body.
Zilucoplan | ZILBRYSQ
Zilucoplan, also known as ZILBRYSQ, is in a class of medications called compliment inhibitors. It works by blocking the activity in part of the immune system that causes the symptoms of MG.
Fourth-Line Treatments & Therapies
Rituximab
Rituximab injection products are in a class of medications called monoclonal antibodies.
Fifth-Line Treatments & Therapies
Cyclophosphamide
Cyclophosphamide is in a class of medications called alkylating agents. It works by suppressing your body's immune system.
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