Treatment of Myasthenia Gravis with Antibodies to Muscle-Specific Kinase (MuSK-Ab+)
Clinical Scenario
This protocol addresses patients with myasthenia gravis who are positive for antibodies to muscle-specific kinase (MuSK-Ab+) — a distinct serological subtype that calls for a specific, targeted treatment strategy.
Treatment Approach
Rituximab is considered as an early therapeutic option in this population. The full structured protocol specifies the regimen, including dosing schedule and sequencing, based on evidence from multicenter studies in MuSK-Ab+ patients.
Complete dosing details, sequencing, and regimen are available in the full protocol below.
Treatment Goal
Achieve minimal manifestation (MM) status — the primary clinical endpoint targeted in MuSK-Ab+ myasthenia gravis.
References
DOI: 10.1212/WNL.0000000000011124
- Rituximab should be considered as an early therapeutic option in patients with MuSK-Ab+ MG who have an unsatisfactory response to initial immunotherapy.
- A multicenter blinded prospective review of MuSK-Ab+ MG patients demonstrated that 14 of 24 (58%) patients treated with RTX achieved MM status and required only low-dose IS therapy, compared with 5 of 31 (16%) of the non-RTX group.
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