Abstract

Immunosuppressive therapy of myasthenia gravis is important for long-term maintenance of remission with minimal side effects. Indication for immunosuppressive treatment is dependent on the severity and course of the disease, and has to take into account the effect of thymectomy which is eventually performed in early-onset generalized myasthenia. Azathioprin is the only drug formally approved for treatment of myasthenia. However, a variety of other immunosuppressants, such as cyclosporine, mycophenolate, cyclophosphamide, and tacrolimus, have also been shown to be effective and can be prescribed off-label as second-line treatment in cases with inefficacy or intolerable side effects of azathioprine.

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