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Fatigue in Myasthenia Gravis: Recent Advances and Emerging Concepts

Yvonne J M Campman1, Martijn R Tannemaat1, Annabel M Ruiter1

  • 1Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.

Muscle & Nerve
|July 1, 2026
PubMed

Insights

Fatigue significantly impacts myasthenia gravis (MG) patients, affecting about 60% of individuals. Research highlights links to disease severity and suggests inflammation may play a role, necessitating targeted treatments.

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.
Keywords:
low‐grade inflammationnon‐pharmacological interventionspatient‐reported outcomesregistry‐based researchtargeted immunotherapy

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