Webb_2025_Neurol.Ther__

INTRODUCTION: Generalised myasthenia gravis (gMG) is a rare autoimmune disorder presenting as variable skeletal muscle weakness and fatigue. Comorbidities are common and symptoms are unpredictable and fluctuating. Many patients rely on immunosuppressive treatments including corticosteroids in their disease management, despite adverse events (AEs) associated with extended or high-dose use. We aimed to investigate clinical characteristics, treatment patterns, and disease burden of patients diagnosed with gMG across the Asia-Pacific region. METHODS: Data were drawn from the Adelphi Real World gMG Disease Specific Programme, a cross-sectional survey of neurologists and their patients with gMG in Australia, China, Japan, South Korea, Malaysia, and Taiwan, from July 2023 to January 2024. Neurologists reported clinical characteristics from diagnosis, current maintenance treatment initiation, and at survey completion. RESULTS: Neurologists (n = 173) reported data on 407 patients with gMG. At the time of survey, mean (standard deviation) patient age was 51.5 (15.3) years and 58.2% were female. Also at survey, 77.6%, 20.1%, and 2.2% of patients had a Myasthenia Gravis Foundation of America class of II, III, or IV, respectively. Since diagnosis, myasthenic crises (22.5%) or exacerbations (37.2%) were reported for most patients (52.7%). Acetylcholinesterase inhibitors (82.8%) and corticosteroids (69.5%) were most commonly prescribed gMG treatments at survey completion, and 65.1% of patients were not in pharmacological remission. AEs were experienced by 71.0% of those prescribed corticosteroids. Joint effects of corticosteroid dose and duration on the increased number of comorbidities and AEs was significant (p = 0.0319). CONCLUSION: Across the Asia-Pacific, most patients did not achieve pharmacological remission despite prescribed treatments, and experienced treatment-related AEs, indicating significant unmet clinical needs. It is suggested that corticosteroid overreliance in maintenance treatment could be associated with increases in comorbidities and AEs. Further research is needed to understand how novel treatments could impact clinical outcomes and reduce corticosteroid reliance for patients with gMG in the Asia-Pacific.