Die Behandlung der Myasthenia gravis im Wandel: Chancen und Herausforderungen klassischer und neuer Therapieansätze

Zusammenfassung

Die therapeutischen Konzepte zur Behandlung der Myasthenia gravis (MG) befinden sich derzeit in einem umfassenden Paradigmenwechsel. Über Jahrzehnte basierten sie auf etablierten Basistherapien mit klinisch belegter Wirksamkeit jedoch begrenzter Evidenz nach modernen Standards. Mit der Einführung zielgerichteter Immuntherapien, die zusätzlich zur Basistherapie eingesetzt werden, haben sich die therapeutischen Möglichkeiten erweitert. Trotz innovativer Optionen bleibt die Basistherapie bei einem Großteil der Patient:innen wirksam und sichert eine adäquate Krankheitskontrolle. Patient:innen mit aktivem oder therapierefraktärem Verlauf profitieren von modernen Add-on-Therapien mit raschem Wirkungseintritt und gezieltem Wirkmechanismus. Dieser narrative Übersichtsartikel beleuchtet die Chancen und Herausforderungen beider Strategien – der klassischen Basistherapie und neuen zielgerichteten Immuntherapien – und diskutiert deren Stellenwert im Rahmen moderner Behandlungskonzepte der MG.

Abstract

Therapeutic approaches for the treatment of myasthenia gravis (MG) are currently undergoing a major paradigm shift. For decades, they have been based on a few well-established basic therapies with clinically proven efficacy, but limited evidence by modern standards. With the introduction of targeted immunotherapies, which are usually used in addition to first-line therapy, the therapeutic options have expanded significantly. Despite innovative options, the majority of patients continue to benefit from first-line therapy and achieve adequate disease control. Patients with a (highly) active or refractory disease course may benefit from modern add-on therapies with rapid onset of action and targeted mechanism of action. This narrative review article highlights the opportunities and challenges of both strategies – classical basic therapy and new targeted immunotherapies – and discusses their importance in the context of modern treatment concepts for MG.

Schlüsselwörter

Myasthenia Gravis - Neuroimmunologie - Immuntherapie - Neue Therapien - Chancen und Herausforderungen

Keywords

Myasthenia gravis - Neuroimmunology - Immunotherapy - Opportunities and challenges - New therapies

Publication History

Article published online:
03 November 2025

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