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AAN 2023 | Diagnosis & management of myasthenia gravis: practical strategies for improved patient care

James F. Howard, Jr., MD, FAAN, University of North Carolina School of Medicine, Chapel Hill, NC, shares practical ways to improve the diagnosis and management of generalized myasthenia gravis (gMG). Improving the diagnosis of gMG relies on a clinical approach that emphasizes listening to patients and paying attention to their reported symptoms. It is crucial to take the time to understand the subtleties of the disease, particularly weakness that worsens with activity and improves with rest but recurs upon resuming the activity. By listening to patients, healthcare practitioners can better identify the key clues that lead to an accurate diagnosis. Social media has played a role in improving diagnosis as patients actively search for information and may approach medical professionals with their own suspicions of having gMG. This increased awareness and patient involvement facilitated by social media platforms have proven to be helpful in the diagnostic process. In terms of management, a significant step forward would be the development of a biomarker that can predict therapeutic responsiveness and the natural course of the disease. Currently, the absence of a reliable biomarker puts the field behind in terms of providing optimal care. Comparatively, conditions like multiple sclerosis have benefited from biomarkers such as MR scans, which have demonstrated the efficacy of new therapeutics. A similar focus on achieving a biomarker for gMG would significantly enhance patient care by enabling healthcare professionals to identify patients who may or may not respond to certain treatments much more efficiently. By incorporating these practical strategies, including attentive listening during the diagnostic process and prioritizing the development of a biomarker, healthcare professionals can improve the accuracy and timeliness of diagnoses and enhance the overall management and quality of care provided to individuals with gMG. This interview took place at the American Academy of Neurology Annual Meeting in 2023 in Boston, MA.

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Research support paid to institution: Alexion Pharmaceuticals, Argenx, Cartesian Therapeutics, The Centers for Disease Control and Prevention, Millennium/Takeda Pharmaceuticals, National Institutes of Health, PCORI, Ra Pharmaceuticals (now UCB)
Honoraria: Alexion Pharmaceuticals, Argenx, Biologix Pharma, Ra Pharmaceuticals (now UCB), F. Hoffmann-LaRoche Ltd, Immunovant, Merck EMB Serono, NMD Pharma, Novartis Pharma, Regeneron Pharmaceuticals, Sanofi US, Toleranzia AB, Horizon Therapeutics, Zai Labs
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