Myasthenia Gravis (MG), a neuromuscular autoimmune disease that causes varying degrees of muscle weakness. The disease usually affects the patient’s face and eye muscles, causing problems with talking, breathing, and vision. Research has been made to develop multiple treatments and diagnosis methods, with various levels of success. This paper seeks to review two articles done on the topic of Myasthenia Gravis
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Speaking of various papers made on the topic, Wolfe (2016) in his article, focuses on the use of thymectomy for treating MG in randomized trials to determine the benefits and effectiveness of this particular treatment method. Gilhus and Verschuuren, on the other hand, examine the various types of MG, their causes, symptoms, possible types of treatment, and their effectiveness. To start off, the latter paper describes its epidemiology and how the disease functions and, stating that it reaches its peak in women of about 30 years and shows a steady incidence increase in men aged over 50 (Gilhus & Verschuuren, 2015). According to Gilhus and Verschuuren (2015), MG does not seem to display geographical variation, excluding one of the subtypes, Juvenile Myasthenia Gravis, which is more prevalent in East Asia.
Gilhus and Verschuuren (2015) touch on the currently available methods of handling various forms of Myasthenia Gravis, naming symptomatic and immunosuppressive drug treatments, thymectomy, and supportive treatment. Wolfe (2016) discusses the effectiveness of thymectomy, comparing the treatment results of 126 patients, ages 18 to 65. The authors state, that “Patients who underwent thymectomy had a lower time-weighted average Quantitative Myasthenia Gravis score over a 3-year period than those who received prednisone alone (6.15 vs. 8.99, P<0.001” (Wolfe et al., 2016, pp. 511). As for supportive treatment, Gilhus and Verschuuren (2015) suggest physical activity and low or medium intensive training provide both short-term and long-term benefits, though they also note an absence of controlled studies on the topic.
The first paper concludes by saying that while most cases of MG are well-controllable, the patients often require long-term treatment, and specific treatments for different variations of the illness are not present at the moment. The authors suggest that newly developed traditional drugs should be tested under strict monitoring. In his research Wolfe (2016) states that over the 3 years, the use of thymectomy improved the outcomes in patients diagnosed with nonthymomatous myasthenia gravis.
The article by Gilhus and Verschuuren has displayed a detailed understanding of the topic, covering the most important aspects of treatment, symptoms, and causes of Myasthenia Gravis, as well as noted the missing information in the research of this disease. The drawback of this paper, however, is the relative lack of information on supporting treatment and training programs. Further investigation into this method of treatment should be made. The study by Wolfe (2016), while examining the effectiveness of the treatment, has a relatively small sample size, which calls the application of the results into question. Furthermore, all of the patients were between the ages of 18 and 65, meaning that the effects of the treatment on the younger and older people are not accounted for. It would be preferable to re-examine the effects of thymectomy on the patients using a larger number and a wider range of participants.
In conclusion, Myasthenia Gravis is a well-researched disease with multiple available treatment methods that mostly succeed in suppressing the symptoms. The two papers that were examined contribute by providing an overview of the specifics of the illness and its treatment. The first article is focused on providing ideas for future drug development, and the second aims at testing one of the already available methods. All in all, further research needs to be conducted regarding the specific treatment of its different forms, as well as the supportive treatment of the symptoms.
Gilhus, N. E., & Verschuuren, J. J. (2015). Myasthenia gravis: Subgroup classification and therapeutic strategies. The Lancet Neurology, 14(10), 1023–1036.
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Wolfe, G. I., Kaminski, H. J., Aban, I. B., Minisman, G., Kuo, H.-C., Marx, A., Ströbel, P., Mazia, C., Oger, J., Cea, J. G., Heckmann, J. M., Evoli, A., Nix, W., Ciafaloni, E., Antonini, G., Witoonpanich, R., King, J. O., Beydoun, S. R., Chalk, C. H., … Cutter, G. R. (2016). Randomized trial of thymectomy in myasthenia gravis. New England Journal of Medicine, 375(6), 511–522.