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Although international guidelines recommend achieving minimal manifestations as the primary treatment goal, the lack of a standardized measurement approach has limited its application in clinical settings and trials. Minimal Symptom Expression (MSE), defined as a Myasthenia Gravis Activities of Daily Living (MG\u2010ADL) score of 0 or 1, has recently emerged as a practical, patient\u2010centric endpoint that reflects minimal functional burden and aligns with regulatory priorities around patient\u2010reported outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This position paper examines the rationale for MSE as a clinically meaningful, actionable treatment target in gMG. We summarize the strengths of the underlying MG\u2010ADL scale and highlight phase 3 trial data showing that MSE is attainable with biologic therapies, including complement and neonatal Fc receptor inhibitors. Data also suggest that achieving MSE correlates with improvements in physician\u2010assessed outcomes and quality of life metrics. However, inconsistencies in how sustained MSE is defined and reported limit comparability across trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MSE, as a patient\u2010centric endpoint, can be used alongside clinician\u2010assessed measures and safety measures to support an integrated treatment goal that encompasses both efficacy and tolerability for the treatment of gMG. Future research should further define the clinical utility of MSE and sustained MSE and incorporate stakeholder input to validate MSE as a part of an integrated treatment goal in both clinical trials and real\u2010world clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70563","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T09:28:32Z","timestamp":1773912512000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Minimal Symptom Expression in Generalized Myasthenia Gravis: A Valuable Patient\u2010Centric Treatment Goal"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7233-5342","authenticated-orcid":false,"given":"Andreas","family":"Meisel","sequence":"first","affiliation":[{"name":"Department of Neurology With Experimental Neurology Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9252-1863","authenticated-orcid":false,"given":"Akiyuki","family":"Uzawa","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine Chiba University  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia Z.","family":"Qi","sequence":"additional","affiliation":[{"name":"Argenx Inc.  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dustin","family":"Nowacek","sequence":"additional","affiliation":[{"name":"Argenx Inc.  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff","family":"Guptill","sequence":"additional","affiliation":[{"name":"Argenx Inc.  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"James F.","family":"Howard","sequence":"additional","affiliation":[{"name":"Department of Neurology The University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-019-0079-y"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-823912-4.00026-8"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-023-11733-y"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000002790"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000011124"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-025-12922-7"},{"key":"e_1_2_15_8_1","first-page":"1637","article-title":"FcRn Inhibitors: A Novel Option for the Treatment of Myasthenia Gravis","volume":"18","author":"Zhu L. 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