Figure 1.

Proposed algorithm for treatment of myasthenia gravis.¹⁵ Presence of antibody or positive response to therapy is indicated by ‘+’; absence of antibody or lack of response to treatment is indicated by ‘−’. Solid blue lines indicate next steps in either diagnosis or treatment. Dashed lines refer to subsequent potential diagnostic or treatment options. Solid red lines refer to treatment options for refractory MG.

Abs, antibodies; AChE, acetylcholinesterase; AChR, acetylcholine receptor; B-MG, bulbar myasthenia gravis; EMA, European Medicines Agency; FDA, US Food and Drug Administration; GI, gastrointestinal; G-MG, generalized myasthenia gravis; IVIg, intravenous immunoglobulin; MG, myasthenia gravis; MuSK, muscle-specific tyrosine kinase; O-MG, ocular myasthenia gravis; RCT, randomized controlled trial; R-MG, respiratory myasthenia gravis; TPE, therapeutic plasma exchange.

Modified from Mantegazza et al.¹⁵ Used with permission.