Table 2.
Demographical, clinical, and therapeutic characteristics of the patients with rheumatoid arthritis and myasthenia gravis
| Age (yrs) | Sex | Myasthenia gravis | Rheumatoid arthritis | Antirheumatic therapies | Clinical course | |
|---|---|---|---|---|---|---|
| Oono et al., 2018 [20] | 36 | F |
Generalized, thymectomy, seropositivity not specified, MM-2 |
Seropositivity not specified Remission |
MTX, GC |
No impact on MG was reported Comorbidity: rheumatoid meningitis (managed with GC increase) |
| Novella-Navarro et al., 2018 [21] | 66 | F |
ocular, anti AchR + , new-onset |
ACPA + , RF + Remission |
MTX, ETN, RTX | MG onset after 6 weeks of ETN and 23 months of MTX. RTX (1000 mg, then 500 mg every 6 months) led to the remission of both MG and RA |
| Angelucci et al., 2010 [19] | 68 | F |
Seropositivity not specified, PR |
Seropositivity not specified Remission |
GC, AZA, ADA |
No impact on MG was reported. Exacerbation of MG after antirheumatic drugs withdrawal for pneumonia Comorbidity: Crohn’s disease, Uveitis |
| Horai et al., 2014 [22] | 73 | M |
Manifestation not specified, seropositivity not specified, MM-2 |
ACPA + new-onset |
MTX, GC | No impact on MG was reported |
| Kerkeni et al., 2008 [23] | 50 | F |
Generalized, anti-AchR + , new-onset |
Seronegative active |
GC, MTX, AZA, IVIG, PEEX, RTX |
New-onset of MG and active RA, therapy with AZA, IVIG, and PEEX ineffective; RTX (375 mg/m2 weekly over 4 weeks) led to remission of both MG and RA |
| Pelachas et al., 2020 [24] | 42 | F |
Ocular, seronegative, new-onset |
RF + , remission |
MTX, ADA | MG onset after 18 months of ADA and 24 months of MTX |
| Fee et al., 2009 [25] | 66 | M |
Generalized, anti-AchR + , new-onset |
RF—no additional information | ETN | MG onset after 6 yrs of ETN, resolution after suspension |
| Wakata et al., 2001 [26] | 56 | F |
Generalized, thymectomy, anti-AchR + , MM-0 |
RF + , new-onset |
Diphenyl sulfone auranofin loxoprofen sodium |
Resolution of RA, no impact on MG was reported |
| Zis et al., 2014 | 69 | M |
Generalized anti-AchR + , new-onset |
ACPA + , new-onset |
GC | Simultaneous onset of MG and RA, GC (75 mg/day) treatment led to remission of both |
| Described case 1 | 48 | M | Generalized anti-AchR + , MM-2 |
ACPA + , RF + active |
MTX, UPA | UPA and MTX led to remission of RA, with no impact on MG |
| Described case 2 | 55 | F |
Generalized anti-AchR + MM-2 |
ACPA + , RF- active |
LEF, UPA | UPA and LEF led remission of RA, with no impact on MG |
| Described case 3 | 54 | F |
Generalized, anti-AchR + , MM-2 |
ACPA + , RF + active | GC, HCQ, CTZ-peg | CTZ-peg led to remission of RA, with no impact on MG |
ACPA,anti-citrullinated peptide antibodies; ADA, adalimumab; Anti-AchR, anti-acetylcholine receptor antibodies; AZA, azathioprine; CTZ-peg, certolizumab pegol; ETN, etanercept; FU, follow-up; GCs, glucocorticosteroids; HCQ, hydroxychloroquine; IVIG, intravenous immunoglobulin; LEF, leflunomide; MG, myasthenia gravis; MM-0, no MG treatment received for at least 1 year; MM-2, minimal manifestations (only low dose cholinesterase inhibitors); MTX, methotrexate; PEEX, plasma-eritroexchange; PR, pharmacologic remission; RA, rheumatoid arthritis; RF, rheumatoid factor; RM, rheumatoid meningitis; RTX, rituximab; UPA, upadacitinib; yrs, years