{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:51:40Z","timestamp":1791348700341,"version":"4.3.1"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T00:00:00Z","timestamp":1676505600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100015661","name":"UCB Pharma","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/100015661","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction\/Aims<\/jats:title><jats:p>Limited knowledge exists on treatment patterns in clinical practice in patients with myasthenia gravis (MG). In this study we examined MG treatment patterns in the United States.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adult patients newly diagnosed with MG were identified from the IBM MarketScan insurance claims database. Patients with \u22652 MG International Classification of Disease diagnosis codes \u22653\u2009months apart were retrospectively followed from the date of their first MG diagnosis record or start of treatment with acetylcholinesterase inhibitors (AChEI), intravenous (IV) or subcutaneous (SC) immunoglobulin (Ig), or plasma exchange (PLEx) therapy. Based on treatment received at any time during the follow\u2010up period, patients were segmented into six main treatment cohorts. Exacerbations and use of IVIg, SCIg, or PLEx after the index date were identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During 2010 to 2019, 7,194 patients were followed for up to 10 (median, 2.3) years. Of 6,539 treated patients, 6,462 (99%) were ever treated with AChEI and\/or corticosteroids (CS); 95% were first treated with AChEI and\/or CS only; 33% received \u22651 nonsteroid immunosuppressive treatment (IST) and 2% received a biologic. During treatment with first IST (n = 2,166), patients experienced 42% and 94% higher incidence rates of exacerbations and IVIg, respectively, compared with AChEI and\/or CS (n = 6,242), and 33% and 23% higher, respectively, compared with a second IST (n = 353).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Many patients experienced exacerbations and received rescue therapy despite treatment, suggesting current treatments may not provide adequate disease control for some patients and that additional treatment options should be explored.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.27791","type":"journal-article","created":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T07:01:05Z","timestamp":1675234865000},"page":"297-305","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Treatment patterns in myasthenia gravis: A United States health claims analysis"],"prefix":"10.1002","volume":"67","author":[{"given":"Milada","family":"Mahic","sequence":"first","affiliation":[{"name":"Global Real World Evidence UCB Pharma  Slough UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Bozorg","sequence":"additional","affiliation":[{"name":"Clinical Development UCB Pharma  Morrisville North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Rudnik","sequence":"additional","affiliation":[{"name":"Real World Data Analytics Team UCB Pharma  Warszawa Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Zaremba","sequence":"additional","affiliation":[{"name":"Real World Data Analytics Team UCB Pharma  Katowice Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4727-9243","authenticated-orcid":false,"given":"Anna","family":"Scowcroft","sequence":"additional","affiliation":[{"name":"Global Real World Evidence UCB Pharma  Slough UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,16]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000002790"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.00604"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756286419832242"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.25205"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000011124"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-015-0398-y"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/practneurol-2015-001126"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.14547"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.4103\/0028-3886.144438"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/1941875210382918"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-019-0079-y"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.3988\/jcn.2019.15.3.376"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.538"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-13-132"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-8-129"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.23398"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0206754"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12955-015-0298-1"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-012-1170-2"},{"issue":"4","key":"e_1_2_11_21_1","doi-asserted-by":"crossref","first-page":"472","DOI":"10.4103\/aian.AIAN_472_19","article-title":"Myasthenic crisis\u2010\u2010\u2010comorbidities, complications, long\u2010term outcomes: the challenges","volume":"22","author":"Murthy JMK","year":"2019","journal-title":"Ann Indian Acad Neurol"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.4103\/0028-3886.15050"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2018.01299"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.662856"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.22212"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40273-020-00912-8"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.20950"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26695"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2016.01.003"}],"container-title":["Muscle &amp; 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