Association of British Neurologists (ABN) autoimmune myasthenia gravis management guidelines (2025 update).
Jacob, Saiju Farrugia, Maria Elena Hewamadduma, Channa Norwood, Fiona Hill, Marguerite Leite, Maria Isabel McConville, John Paul Pinto, Ashwin Arnold Spillane, Jennifer Sussman, Jon
Jacob, Saiju
Farrugia, Maria Elena
Hewamadduma, Channa
Norwood, Fiona
Hill, Marguerite
Leite, Maria Isabel
McConville, John Paul
Pinto, Ashwin Arnold
Spillane, Jennifer
Sussman, Jon
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Other Contributors
Publication date
2025-09-12
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Abstract
The 2025 update of the Association of British Neurologists guidelines for the management of autoimmune myasthenia gravis (MG) emphasises several points that are distinct from the 2015 guidelines based on recent research and publications. The main differences from the previous guidelines are: (1) The recommendation to prescribe daily steroids rather than the alternate day regimen is now standard practice. (2) There is a clear emphasis on the beneficial effects of early thymectomy. (3) Randomised controlled trial evidence now supports early use of rituximab (within 1 year of generalised disease onset), although the evidence is less robust, but still likely to be useful, in established treatment-refractory MG. (4) Finally, several clinical trials have been published for newer targeted therapies in MG, predominantly those that inhibit the complement and neonatal Fc gamma receptor pathways, the roles of which are being slowly established especially in patients unresponsive to conventional therapy.
Citation
Jacob S, Farrugia ME, Hewamadduma C, Norwood F, Hill M, Leite MI, McConville JP, Pinto AA, Spillane J, Sussman J, Viegas S. Association of British Neurologists (ABN) autoimmune myasthenia gravis management guidelines (2025 update). Pract Neurol. 2025 Sep 12;25(5):422-437. doi: 10.1136/pn-2025-004655.
Type
Guideline