Myasthenia gravis is a chronic autoimmune disorder that inhibits communication between nerve cells and muscles, causing muscle weakness. It has no cure, but several treatment options can help improve symptoms.

Myasthenia gravis used to be a terminal illness. The condition, marked by weakness and rapid fatigue of muscles under a person’s voluntary control, often leads to severe breathing issues or pneumonia. This resulted in premature death within a few years of diagnosis.

However, medication advancements help people diagnosed with myasthenia gravis live typical life spans. Many enter long-lasting remission or experience a period with reduced symptom severity.

Since its introduction in the 1930s, acetylcholinesterase (AChE) inhibitors remain a standard treatment option to help control symptoms of myasthenia gravis.

This non-immunosuppressive medication helps block AChE from breaking down acetylcholine (ACh). This increases the available supply of ACh at neuromuscular junctions (NMJ) to bind to postsynaptic ACh receptors.

The result is a temporary relief of muscle weakness.

If AChE inhibitors are not effective enough or do not work, corticosteroids are the first line of immunosuppressive medication. Evidence suggests that early introduction of steroid therapy helps improve or delay ocular symptoms in people who experience eye issues.

Also, steroid therapy can help a person reach early and long-term resolution of symptoms. About 70–80% of people experience marked symptom reduction or complete remission, according to a 2020 reappraisal of oral steroid therapy.

It can take between 4 and 8 weeks for symptoms to improve after starting corticosteroids.

Several other medications may help people whose symptoms do not improve with either first-line treatment option.

Additional immunotherapy options and biologics (medications made from living cells) can help target the immune system and stop it from attacking healthy cells.

If you are living with myasthenia gravis, consider working with a healthcare professional familiar with the condition. They can help find treatment methods that work best for you.

There is no cure for myasthenia gravis.

With current treatment options, most people with the condition live a usual life span. In the early 20th century, people diagnosed with myasthenia gravis often passed away within 1 to 2 years from respiratory failure and pneumonia.

Medications and other therapies, such as regular physical activity, can help improve symptoms and manage myasthenia gravis.

Several medications can treat myasthenia gravis. Medications make it possible for most people to go into remission of their symptoms and live an ordinary life span.

In some cases, a person may be able to stop taking medications altogether if their symptoms go into remission, but they need to speak with a healthcare professional before stopping medications.

If you are living with myasthenia gravis, you may find that gentle, regular physical activity helps with symptoms. Examples of gentle exercises can include:

  • walking
  • swimming
  • yoga
  • some forms of dance
  • cycling
  • pilates
  • stretching
  • water aerobics

In 2023, Rozanolixizumab (RYSTIGGO®) gained Food and Drug Administration (FDA) approval for treatment of myasthenia gravis. This biological medication targets a specific part of the immune system — the neonatal Fc receptor (FcRn).

The FDA approved it for people who are anti-acetylcholine receptor (AChR) or anti-muscle-specific kinase (MuSK) antibody positive, both of which which induce myasthenic weakness by inhibiting normal neuromuscular signaling. The biologic is the first one available that targets both AChR and MuSK.

Several types of medication can cause myasthenia gravis to worsen, cause new symptoms, or create myasthenia gravis-like symptoms. Some types of medications that can cause worsening symptoms:

  • penicillamine
  • tyrosine kinase inhibitors
  • immune checkpoint inhibitors
  • interferons
  • antibiotics
  • neuromuscular blockers
  • antiarrhythmics
  • anesthetics

It is important to speak with a healthcare professional if you notice new or worsening symptoms when taking a new medication. Also, it is essential to review your current medications with a healthcare professional when diagnosed with myasthenia gravis so they can help modify existing medications if needed.

Stem cell therapy is available for some people living with refractory myasthenia gravis — an aggressive form of the condition that does not respond to conventional treatments.

Currently, hematopoietic stem cell transplantation is available. One 2019 case study indicated this treatment is well tolerated and helps improve symptoms.

Other studies suggest that it is associated with several side effects and adverse effects, as well as an extended hospitalization for administration. Possible side effects can include:

  • mucositis (inflamed mouth or gut)
  • mortality rate of 6–8%
  • neutropenia (abnormally low count of white blood cells)
  • increased risk of infections
  • development of secondary autoimmune disorders
  • increased risk of certain cancers
  • organ toxicity

Other types of stem cell therapy, such as preconditioned mesenchymal stem cells, may eventually provide another option. A 2017 study found evidence suggesting that it can have anti-inflammatory and immunosuppressive effects primarily in the thymus, causing symptom improvement.

Additional research is needed to determine the stem cell therapy’s safety and effectiveness.

Several treatment options can help treat the symptoms and reduce the severity of myasthenia gravis.

The condition has no cure, but medications and treatments can help a person live a healthy life. Many can enter complete or partial remission with the proper medications.