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Objective <p>This paper provides an update to the 2019 Italian recommendations for the diagnosis and management of myasthenia gravis (MG), incorporating the most recent evidence from the literature. It focuses on serological diagnosis, clinical assessment, and emerging therapeutic strategies for MG, adapted to the Italian healthcare context.</p> Methods <p>A new consensus was developed for specific topics identified by the clinical task force, including 16 clinical experts and one patient representative. Consensus on specific statements was achieved using the anonymized Welphi platform. Up to three rounds of anonymous voting were conducted to reach agreement, with iterative modifications to recommendations between rounds based on online and/or in-person meetings involving all participants. Revised statements were resubmitted for additional voting rounds as necessary.</p> Results <p>The recommendations for antibody assays in the diagnosis of MG were updated. New guidance was also formulated regarding the use of clinician-reported and patient-reported outcome measures, along with the integration of emerging therapeutic options such as B-cell–depleting therapies, complement inhibitors, and FcRn inhibitors. A comprehensive review of strategies to prevent treatment-related adverse events and recommendations for vaccination schedules were also provided.</p> Conclusion <p>These updated recommendations, grounded in new evidence, aim to support clinicians in the care of patients with MG. The integration of novel immunomodulatory therapies with conventional treatment regimens - alongside assessment of antibody status, use of validated clinical scales, and the implementation of preventive measures - represents a key step toward optimizing outcomes for patients with MG within the Italian healthcare system.</p>

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Italian recommendations for the diagnosis and treatment of myasthenia gravis

  • 期刊论文

  • 发表日期：

    2026年3月20日

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  • Laura Fionda,
  • Paolo Emilio Alboini,
  • Carlo Antozzi,
  • Domenico Marco Bonifati,
  • Valentina Damato,
  • Francesco Habetswallner,
  • Maurizio Inghilleri,
  • Raffaele Iorio,
  • Rocco Liguori,
  • Michelangelo Maestri Tassoni,
  • Lorenzo Maggi,
  • Renato Mantegazza,
  • Roberto Massa,
  • Elena Pegoraro,
  • Carmelo Rodolico,
  • Mariangela Pino,
  • Giovanni Antonini,
  • Amelia Evoli

摘要

Objective

This paper provides an update to the 2019 Italian recommendations for the diagnosis and management of myasthenia gravis (MG), incorporating the most recent evidence from the literature. It focuses on serological diagnosis, clinical assessment, and emerging therapeutic strategies for MG, adapted to the Italian healthcare context.

Methods

A new consensus was developed for specific topics identified by the clinical task force, including 16 clinical experts and one patient representative. Consensus on specific statements was achieved using the anonymized Welphi platform. Up to three rounds of anonymous voting were conducted to reach agreement, with iterative modifications to recommendations between rounds based on online and/or in-person meetings involving all participants. Revised statements were resubmitted for additional voting rounds as necessary.

Results

The recommendations for antibody assays in the diagnosis of MG were updated. New guidance was also formulated regarding the use of clinician-reported and patient-reported outcome measures, along with the integration of emerging therapeutic options such as B-cell–depleting therapies, complement inhibitors, and FcRn inhibitors. A comprehensive review of strategies to prevent treatment-related adverse events and recommendations for vaccination schedules were also provided.

Conclusion

These updated recommendations, grounded in new evidence, aim to support clinicians in the care of patients with MG. The integration of novel immunomodulatory therapies with conventional treatment regimens - alongside assessment of antibody status, use of validated clinical scales, and the implementation of preventive measures - represents a key step toward optimizing outcomes for patients with MG within the Italian healthcare system.