What is MG?

gMG is a rare, chronic autoimmune neuromuscular disease Rare autoimmune disease of the NMJ that may result in chronic impaired muscle function1

gMG is a rare, chronic autoimmune disease that Targets the NMJ1
gMGis characterized by fluctuating and fatiguable skeletal muscle weakness1-4
gMGcan affect many muscle groups, including ocular, bulbar, limb, axial and respiratory muscles1-4

What are the symptoms of gMG?

axial
Ocular
  • Droopy eyelids
  • Double vision
axial
Bulbar
  • Difficulty speaking
  • Jaw fatigue
axial
Limb
  • Weakness in the arms, hands, fingers, and legs
axial
Facial
  • Poor cheek puff
  • Drooling
axial
Axial
  • Weakness in the neck
axial
Respiratory
  • Fast breathing
  • Respiratory failure

Prevalence and incidence of MG

The worldwide prevalence of MG is estimated to be between 80 and 278 per million1-7

mg-prevalence

Manifestation of MG

ocular
MG often first manifests as weakness of ocular muscles1,2
ocular
In about three-quarters (75-80%) of patients with ocular MG, disease eventually generalizes to affect the face, neck, hands and/or limbs, and/or respiratory muscles2-5
Bulbar Muscles
  • Jaw fatigue/difficulty chewing
  • Difficulty swallowing (dysphagia)
  • Nasal speech (dysarthria)
  • Hoarseness (dysphonia)
Respiratory Muscles
  • Diaphragm weakness/difficulty breathing
  • Respiratory failure

Characterized by fluctuating and fatigable muscle weakness,often in the ocular muscles

In 80%of patients, the disease generalizes

(gMG)to affect other muscles

Unpredictable gMG symptom fluctuations lead to a profound burden

96% experienced symptom fluctuations In concept elicitation interviews conducted in 28 adult patients with gMG.

A range of fluctuations
FatigueTrouble swallowingDifficulty breathingImpaired vision
Affecting well-being
PhysicalEmotionalSocialEconomic
Leading to lifestyle trade-offs
Work lifeFamily life
Dr. Areej Bushnaq
Dr. Areej Bushnaq
Consultant Neurologist, Neuromuscular and intraoperative monitoring founder of the women’s neurology chapter - saudi neurology society
Dr. Abubaker Almadani
Dr. Abubaker Almadani
Vice preseident of EMINS consultant & Head of Neurology department rashid hospital Dubai, UAE
Vision problems in gMG
chart Vision problems in gMG

Vision problems in gMG are common and may impact QoL

These issues can have a negative impact on activities of daily living, such as working or driving

Patients rate vision problems as one of the top 2 most burdensome gMG symptoms

~85% of patients with gMG experience ocular muscle weakness, which can be progressive

  • Resultant double vision and ptosis can impact quality of life
  • 54%-79% of patients with gMG (n=22/28, n=245/452, respectively) report double vision

gMG exacerbation and myasthenic crisis

gMG exacerbation
  • Generally defined as significant worsening of gMG symptoms
  • Typically requires inpatient treatmentv
  • The most severe type of gMG exacerbation is myasthenic crisis
Myasthenic crisis1,2
  • Severe weakness in respiratory muscles, leading to respiratory failure and requiring
  • Intubation and mechanical ventilation

Certain factors are associated with worsening of symptoms and with a high risk of exacerbations2

Late onset of disease

Late onset of disease

Late onset of disease

Late onset of disease

Late onset of disease

Late onset of disease

Late onset of disease

Late onset of disease

Late onset of disease

Late onset of disease

Late onset of disease

Late onset of disease

gMG crises

  • Are more common on the first 2 years following disease onset
  • Can cause acute symptoms that impact daily life
  • Can lead to hospitalization, mechanical ventilation, tube feeding, and death
chart

of patients may experience MG-related hospitalizations, moststriking within the first 2-3 years of disease onset

This retrospective longitudinal cohort study evaluated 1149 adult patients with gMG living in England using data recorded from 1997 to 2016

chart

of hospital stays were followed by discharge to a skilled nursing or longterm acute-care facility.

Hospitalized and treated between 2010 and 2019 in USA

Burden of gMG impact multiple aspects of individuals' livesa

chart

Emotional impact

  • Anxiety (82%)
  • Depression/sadness (75%)
  • Frustration (64%)
  • Fear (57%)
  • Embarrassment (54%)
chart

Social impact

  • Dating/partner (57%)
  • Feeling misunderstood (46%)
chart

Physical impact

  • Gross motor impairment (93%)
  • Hobbies and sports (89%)
  • IADLsb (82%)
  • ADLsc (57%)
  • Fine motor impairment (46%)
chart

Other life domains

  • Impact on work/career (100%)
  • Need for increased planning (89%)
  • Sleep disturbances (89%)
  • Needing assistance (64%)