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Because treatment of myasthenia gravis (MG) by experienced neurologists is remarkably successful, recruitment for randomized, controlled trials is challenging. Therefore, experts provide opinions on new evidence available since the previous report in 2016 (Neurology 2016; 87:419).
Thymectomy: A recent trial finally confirmed that sternal-splitting thymectomy produces objective benefit in patients with AChR-Ab+ generalized MG and should be performed early. Thymectomy is not recommended in MuSK-Ab+ MG.
Ocular MG: Treat OMG with prednisone (maybe low-dose), other immunosuppressive agents, or both; thymectomy has equivocal results.
Rituximab …