{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T10:33:05Z","timestamp":1761647585706},"reference-count":52,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2008,6,28]],"date-time":"2008-06-28T00:00:00Z","timestamp":1214611200000},"content-version":"vor","delay-in-days":27,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Annals of the New York Academy of Sciences"],"published-print":{"date-parts":[[2008,6]]},"abstract":"<jats:p>Although once an often fatal illness, myasthenia gravis can now be well managed with relatively safe and effective therapies. Prior to 1960 mortality for myasthenia gravis was approximately 30%. In the current era, mortality should be less than 5%. Major therapeutic advances by decade were: physostigmine and thymectomy (1930s); mechanical ventilation (1950s); corticosteroids and plasmapheresis (1960s); azathioprine (1960s\u20131970s); cyclosporine (1980s); intravenous gamma globulins (1980s\u20131990s); and most recently mycophenolate mofetil (1990s\u20132000s). Modern management involves a graded approach, beginning with cholinesterase inhibitors for mild symptoms and advancing to immunomodulating medications for more severe weakness. We now have several immunomodulating agents from which to choose: selection is based largely on time to clinical effect and adverse effects. The various available treatment modalities all have their limitations. In addition, some controversies remain regarding the effectiveness of some of the commonly used myasthenia gravis treatments. Recently completed and ongoing clinical trials suggest that there is still equipoise regarding the benefit of mycophenolate mofetil and thymectomy. Hopefully, the future will be promising, with clinical trials involving novel immunotherapeutic strategies.<\/jats:p>","DOI":"10.1196\/annals.1405.036","type":"journal-article","created":{"date-parts":[[2008,6,20]],"date-time":"2008-06-20T23:23:28Z","timestamp":1214004208000},"page":"225-232","source":"Crossref","is-referenced-by-count":11,"title":["<i>Treatment and Clinical Research in Myasthenia Gravis<\/i>"],"prefix":"10.1111","volume":"1132","author":[{"given":"Richard J.","family":"Barohn","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2008,6,28]]},"reference":[{"key":"e_1_2_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)94294-6"},{"key":"e_1_2_3_3_2","first-page":"746","article-title":"Thymektomie bei einem Fall von Murbus Basedowi mit Myasthenia","volume":"25","author":"Schumacher C.H.","year":"1913","journal-title":"Mitteilungen Grensgebeiten Medizin Chirurgie"},{"key":"e_1_2_3_4_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.55.1.7"},{"key":"e_1_2_3_5_2","first-page":"311","article-title":"Effect of 3\u2010hydroxy phenyldimethylethyl ammonium chloride (Tensilon) in myasthenia gravis","volume":"17","author":"Westerberg M.R.","year":"1951","journal-title":"Med. Bull. (Ann Arbor)"},{"key":"e_1_2_3_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM195408122510706"},{"key":"e_1_2_3_7_2","first-page":"227","article-title":"Mestinon in myasthenia gravis (preliminary report)","volume":"15","author":"Tether J.E.","year":"1954","journal-title":"Dis. Nerv. Syst."},{"key":"e_1_2_3_8_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.50.6.1778"},{"key":"e_1_2_3_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198703193161205"},{"key":"e_1_2_3_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1993.tb22937.x"},{"key":"e_1_2_3_11_2","first-page":"A137","article-title":"Mycophenolate mofetil (MyM) is safe and well\u2010tolerated in myasthenia gravis (MG) [abstract]","volume":"54","author":"Cos L.","year":"2000","journal-title":"Neurology"},{"key":"e_1_2_3_12_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.56.1.94"},{"key":"e_1_2_3_13_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.56.1.97"},{"key":"e_1_2_3_14_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000094122.88929.0B"},{"key":"e_1_2_3_15_2","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1254.064"},{"key":"e_1_2_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(84)92294-3"},{"key":"e_1_2_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/0090-1229(89)90083-4"},{"key":"e_1_2_3_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.1991.tb04912.x"},{"key":"e_1_2_3_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410410615"},{"key":"e_1_2_3_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/mus.10224"},{"key":"e_1_2_3_21_2","article-title":"Complete remission and autoantibody patterns in MG: a large population study [Abstract]","author":"Antozzi C.","year":"2008","journal-title":"Ann. N.Y. Acad. Sci."},{"key":"e_1_2_3_22_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1964.00460200010002"},{"key":"e_1_2_3_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1976.tb47718.x"},{"key":"e_1_2_3_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.1998.tb05968.x"},{"key":"e_1_2_3_25_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.62.11.1689"},{"key":"e_1_2_3_26_2","doi-asserted-by":"publisher","DOI":"10.1159\/000085833"},{"issue":"1","key":"e_1_2_3_27_2","first-page":"107","article-title":"A trial of mycophenolate mofetil (MMF) with prednisone as initial immunotherapy in myasthenia gravis (MG) (abstract)","volume":"62","author":"Sanders D.","year":"2007","journal-title":"Neurology"},{"key":"e_1_2_3_28_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000256698.69121.45"},{"key":"e_1_2_3_29_2","doi-asserted-by":"crossref","DOI":"10.1196\/annals.1405.031","article-title":"Lessons from two trials of mycophenolate mofetil in myasthenia gravis","author":"Sanders D.B.","year":"2008","journal-title":"Ann. N.Y. Acad. Sci."},{"key":"e_1_2_3_30_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000312373.67493.7f"},{"key":"e_1_2_3_31_2","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1405.038"},{"key":"e_1_2_3_32_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1981.tb33781.x"},{"key":"e_1_2_3_33_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.33.10.1316"},{"key":"e_1_2_3_34_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1998.tb11015.x"},{"key":"e_1_2_3_35_2","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1254.061"},{"key":"e_1_2_3_36_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.55.1.16"},{"key":"e_1_2_3_37_2","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1254.057"},{"key":"e_1_2_3_38_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000147242.92691.71"},{"key":"e_1_2_3_39_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000163988.28892.79"},{"key":"e_1_2_3_40_2","first-page":"939","article-title":"Effets a long terme des echanges plasmatiques au cours de la myasthenia. Resultats d'une etude randomisee","volume":"12","author":"Gajdos P.","year":"1983","journal-title":"Presse Med."},{"key":"e_1_2_3_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(84)90469-0"},{"key":"e_1_2_3_42_2","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1254.058"},{"key":"e_1_2_3_43_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.52.7.1487"},{"key":"e_1_2_3_44_2","first-page":"A63","article-title":"The correlation between static fatigue testing and the quantitative myasthenia gravis score and activities of daily living profile","volume":"56","author":"Herbelin L.L.","year":"2001","journal-title":"Neurology"},{"key":"e_1_2_3_45_2","article-title":"Correlation of outcome measures and static fatigue testing from a controlled study of mycophenolate mofetil in generalized MG [Abstract]","author":"Pasnoor M.","year":"2008","journal-title":"Ann. N.Y. Acad. Sci."},{"key":"e_1_2_3_46_2","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1405.000"},{"key":"e_1_2_3_47_2","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1405.028"},{"key":"e_1_2_3_48_2","article-title":"Clinical response to rituximab and long\u2010term follow\u2010up in treatment\u2010refractory MG [Abstract]","author":"Melms A.","year":"2008","journal-title":"Ann. N.Y. Acad. Sci."},{"key":"e_1_2_3_49_2","doi-asserted-by":"publisher","DOI":"10.1002\/mus.20479"},{"key":"e_1_2_3_50_2","doi-asserted-by":"publisher","DOI":"10.1067\/S0022-3476(03)00300-7"},{"key":"e_1_2_3_51_2","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1405.022"},{"key":"e_1_2_3_52_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.10400"},{"key":"e_1_2_3_53_2","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1405.033"}],"container-title":["Annals of the New York Academy of Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1196%2Fannals.1405.036","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/nyaspubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1196\/annals.1405.036","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T02:23:40Z","timestamp":1695695020000},"score":1,"resource":{"primary":{"URL":"https:\/\/nyaspubs.onlinelibrary.wiley.com\/doi\/10.1196\/annals.1405.036"}},"subtitle":["<i>How Far Have We Come?<\/i>"],"short-title":[],"issued":{"date-parts":[[2008,6]]},"references-count":52,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2008,6]]}},"alternative-id":["10.1196\/annals.1405.036"],"URL":"https:\/\/doi.org\/10.1196\/annals.1405.036","archive":["Portico"],"relation":{},"ISSN":["0077-8923","1749-6632"],"issn-type":[{"value":"0077-8923","type":"print"},{"value":"1749-6632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,6]]}}}