Myasthenia Gravis Crisis: Treatment Challenges & Triggers

Real-World Characterization Of Challenges Related To The Identification & Management Of Myasthenia Gravis Crisis 

This poster was originally presented at Myasthenia Gravis Foundation of America (MGFA) American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) 2023, November 1-4, in Phoenix, AZ. 

Authors: Jonathan Darer, MD, MPH; Jacqueline Pesa, PhD, MPH; Zia Choudhry, MD; Alberto Batista, PharmD, MS; Purva Parab, PhD; Xiaoyun Yang, MS; Raghav Govindarajan, MD 

Affiliations: Health Analytics; Janssen Scientific Affairs; Janssen Pharmaceutical Companies of Johnson & Johnson; Hospital Sisters Health Systems Medical Group 

Introduction 

Myasthenia gravis (MG) is a rare, chronic, autoantibody-mediated neuromuscular disorder affecting approximately 60,000 individuals in the United States. The goal of this study is to characterize the identification, clinical presentation, and management challenges related to individuals with MG crisis based upon chart review of neurologist clinical progress notes. 

Methods  

• Medical transcriptions from Amplity AnswerY™ (formerly known as Amplity Insights™) were used, including the full text from HIPAA-compliant dictated clinical notes covering 150,000 physicians from over 40,000 clinics and hospitals in the United States between 2017 and 2022.  

• A natural language processing model was developed to identify candidate neurologist notes referencing MG crisis. 

Results 

According to Table 1: 

• Of 137 patients with MG crisis, the majority were identified by the terms “MG” and “crisis.”  

• A history of multiple MG crises was found in 19 (14%) patients and 18 (13%) patients reported pneumonia and urinary tract infection as triggering events for MG crisis. 

• According to Table 2, closer examination of physician notes for the 137 patients with documented MG crisis who had MG treatment difficulties revealed specific issues with different standard MG therapies. 

Conclusion 

• MG crises represent unpredictable and potentially life-threatening events.  

• Neurologist documentation of MG crisis highlights the challenges of clinical management, including difficulties with multiple standard MG treatments. 

• Adverse effects, poor treatment response, and interaction with comorbidities are frequent challenges related to MG treatment in MG crisis. 

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