Progress in the Treatment of Refractory Myasthenia Gravis

Myasthenia gravis (MG) is an autoantibody-mediated, cellular immune-dependent and complement system-involved autoimmune disorder characterized by acquired neuromuscular junction transmission dysfunction driven by genetic and environmental factors. Approximately 10% therapies such as cholinesterase inhibitors, glucocorticoids, and immunosuppressants, resulting in the development of refractory MG (RMG). The current emergence of new therapeutic strategies such as targeted biologics (e.g., complement inhibitors, Fc receptor (FcRn) antagonists, etc.), B-cell depletion therapy, and Chimeric Antigen Receptor (CAR)-T cell therapy contribute to the significant improvement in the clinical management of RMG. Accordingly, the present study systematically reviewed the treatment progress of RMG, aiming to provide evidence-based individualized treatment decision-making clinically, alleviate patients' pain, and explore future research directions.