Mixing Old and New: How Different Drugs Are Used to Treat a Rare Muscle Disease

In the United States, people with a condition called generalized myasthenia gravis (gMG) often take medicines to help manage their symptoms. Two types of drugs commonly used are oral corticosteroids (OCSs) and nonsteroidal immunosuppressant therapies (NSISTs). These drugs can have serious side effects, but they are still widely prescribed. Recently, newer drugs have been approved to treat gMG. These include ravulizumab, eculizumab, and efgartigimod. They work in different ways than the older drugs. Some people think that these newer drugs might allow patients to use fewer of the older immunosuppressant drugs. However, there is not much real-world evidence to support this idea yet. A recent study looked at how often people with gMG in the United States are prescribed OCSs and NSISTs along with these newer drugs. The study found that many people are still taking the older drugs, even when they are on the newer treatments. This suggests that the newer drugs may not be replacing the older ones as much as some had hoped. The study also found that the use of OCSs and NSISTs varies depending on which newer drug a person is taking. For example, people taking efgartigimod seem to use fewer of the older drugs than those taking ravulizumab or eculizumab. This could be because efgartigimod works in a different way than the other two drugs. The study has some limitations. It is retrospective, meaning it looks back at data that was already collected. This can make it harder to draw firm conclusions. Also, the study only looked at data from the United States, so it may not apply to people in other countries. Despite these limitations, the study provides valuable information about how these drugs are being used in the real world. It shows that, while newer drugs are becoming more common, the older drugs are still playing an important role in the treatment of gMG.