Cintas_2026_Rev.Neurol.(Paris)__

Myasthenia gravis (MG) is a rare autoimmune disease in which immunoglobulin G autoantibodies targeting post-synaptic receptors at neuromuscular junction play a central role. Due to recent therapeutic developments, there is a need to update current guidelines. FILNEMUS (the French network for rare neuromuscular diseases) conducted a survey in neurologists treating patients with MG to better understand the current clinical and therapeutic management of MG and to identify difficulties and unmet needs. The 45-questions survey assessed various aspects of MG management: including characteristics of neurologists and their patients, the treatments prescribed, and potential areas to improve MG management. Between the 21st of April and the 22nd of August 2022, 2,535 neurologists (90.4%) of the 2,792 registered in France (in 2022) were asked to participate. Finally, 321 complete the survey and were analysed. These population constitute a representative population of neurologists with all French regions and types of medical institutions represented. The survey found that 73.2% of patients with MG are treated by neurologists working in hospitals. Regarding treatment, most neurologists (96.9%) prescribed a cholinesterase inhibitor as first-line treatment most often combined with a corticosteroid (69.1%) or with a non-steroidal immunosuppressant (66.0%). Neurologists working in reference hospital centres tended to prescribe more corticosteroids as first-line treatment for ocular MG and as early disease-modifying treatment for generalized MG. Neurologists identified several aspects of MG management that needed to be improved, including the diagnosis of atypical types of MG, the transfer of patient information from neurologists to general practitioners, the need to optimise existing therapies (improve tolerance and effectiveness), continual medical education for neurologists, as well as the need for improved therapeutic patient education. Our survey shows that evidence from the neurologists' perspective can provide valuable insight into the management of patients with MG and can identify unmet clinical and therapeutics needs.