Fatigue in Myasthenia Gravis: Recent Advances and Emerging Concepts

Area of Science:

• Neurology
• Clinical Medicine
• Patient-Reported Outcomes

Background:

• Fatigue is a prevalent and disabling symptom in myasthenia gravis (MG), distinct from muscle fatigability.
• It significantly reduces patients' quality of life and is linked to disease severity, depression, and inactivity.

Purpose of the Study:

• To review current evidence on fatigue in MG.
• To examine the patient impact of fatigue.
• To identify future research directions for understanding and treating MG fatigue.

Main Methods:

• Narrative review of existing literature.
• Analysis of data from large registry-based studies.
• Examination of findings from phase 3 clinical trials of immunotherapies.
• Consideration of emerging biomarker evidence.

Main Results:

• Consistent prevalence of fatigue in MG established at approximately 60%.
• Fatigue is associated with greater disease severity, depressive symptoms, and physical inactivity.
• Improvements in fatigue observed as a secondary endpoint in immunotherapy trials.
• Emerging evidence suggests systemic low-grade inflammation may contribute to fatigue.

Conclusions:

• Targeted, multidimensional strategies are needed to better understand and manage fatigue in MG.
• Further research into non-pharmacological approaches for MG fatigue is warranted.
• Biomarker research may elucidate the mechanisms underlying MG fatigue.