Do you sometimes feel like your eyes are getting tired as the day goes on, your tongue is slurred when you speak, or your limbs are going numb? These may not just be due to fatigue. Today we are talking about a special condition called ' Myasthenia Gravis ' that causes such symptoms and a new treatment that has been used for it. It is very important to be aware of this.
What exactly is Myasthenia Gravis?
Simply put, myasthenia gravis is a chronic condition in which our body's own defense system, the immune system, mistakenly attacks our own healthy cells. This is called an autoimmune disease.
Imagine, a message sent from our brain travels through the nerves and reaches a muscle, which then acts. The neuromuscular junction between the nerve and the muscle is damaged in this disease. Some antibodies produced by our immune system reach this junction and block the flow of messages. As a result , the muscle gradually starts to weaken .
The two main types of antibodies that cause this problem are anti- acetylcholine receptor (AChR) and anti-muscle-specific tyrosine kinase (MuSK) . Your doctor will explain these to you.
What are the common symptoms of this disease?
These symptoms can vary from person to person. Also, the more you use the muscle, the more it becomes weak. The table below lists some of the most common symptoms.
| Symptom | Description |
|---|---|
| Drooping eyelids | Uncontrolled drooping of one or both eyes. Some people may even see two. |
| Change in facial expression | Weakening of the muscles in the face and jaw can cause changes in things like smiling and expressing anger. |
| Weakness in the arms, legs, and fingers | Difficulty performing daily tasks such as lifting something, combing hair, or walking. |
| Difficulty swallowing | Feeling like you're choking when swallowing food or drink. |
| Difficulty speaking | Changes in voice when speaking, sounds like you are speaking through your nose, or tongue-tied speech. |
How does the new drug Rystiggo work?
Rystiggo (Rozanolixizumab-noli) is a new drug approved for the treatment of myasthenia gravis. It belongs to a class of drugs called neonatal Fc receptor (FcRn) blockers.
Now let's see how this works. As I said before, the cause of this disease is the harmful antibodies (AChR and MuSK) in our blood. What Rystiggo does is target these harmful antibodies and speed up their removal from our body.
Simply put, this medicine works like a filter that cleans our blood and reduces the amount of bad antibodies that cause the disease.
When the amount of these antibodies decreases, the interference with signal transmission between nerves and muscles decreases. As a result, muscle strength increases again and symptoms are controlled.
Is this medicine good for everyone?
No. Rystigmo is only approved for use in adult patients with myasthenia gravis who have been tested for antibodies to AChR or MuSK in their blood. People who do not have these antibodies may not benefit from this medicine. Therefore, your doctor will decide if this treatment is right for you.
How is the treatment given and what are the side effects?
This medication is usually given as an injection into the subcutaneous tissue in a hospital or clinic. This is most commonly given in the area below the belly button.
- Treatment cycle: This vaccine is usually given once a week for 6 weeks. This is called a treatment cycle. After that, you can go without treatment for a while and start a new cycle if necessary. This is all decided by your doctor.
- Caution: You will be kept under medical supervision for about 15 minutes after the injection, as allergic reactions can sometimes occur.
| Risk/side effect | What to do and what to know |
|---|---|
| Situations when you should inform your doctor immediately | |
| Active Infections | If you have symptoms such as fever, body aches, cough, phlegm, difficulty breathing, or diarrhea, tell your doctor immediately before or during treatment. Treatment may need to be postponed until the infection clears up. |
| Common side effects | |
| Headache | This is usually a minor thing. If it is severe or persists, tell your doctor. |
| Nausea and diarrhea | This is common in the first few weeks of treatment. Drink plenty of water and eat bland foods (rice, bananas). If it persists, tell your doctor. |
| Injection site reactions | There may be redness, itching, and swelling at the injection site. This can be reduced by changing the injection site rather than injecting in the same spot each time. |
Can there be problems with other medications and vaccines?
Yes, that is a very important matter.
- Vaccines: Some vaccines cannot be given before or during treatment with Rystiggo. Therefore, tell your doctor in advance about any vaccines you are receiving.
- Other medications: Other medications you are taking, especially immune-related treatments like Intravenous Immunoglobulin (IVIg) , and monoclonal antibodies , may interact with Rystiggo.
Therefore, it is essential to tell your doctor about all medications you take (including vitamins and herbal products) without hiding anything.
How do you know if the medicine is working?
Within a few weeks of starting Rystiggo, you will start to feel your muscles getting stronger and your symptoms getting better. However, even if your symptoms get better, never stop taking the medicine without your doctor's advice. Doing so may make your symptoms come back. Always talk to your doctor about your condition.
Take-Home Message
- Myasthenia Gravis is a disease in which our own immune system attacks our muscles.
- Rystigmo is a new treatment for this disease. It helps remove the harmful antibodies that cause the disease from the body.
- This treatment is not suitable for everyone. Your doctor will determine if this is right for you by checking whether you have AChR or MuSK antibodies in your blood.
- If you develop symptoms of infection such as fever and cough during treatment, notify your doctor immediately.
- It is very important to tell your doctor about all other medications you are taking.
- Avoid stopping prescribed medications without medical advice for any reason.
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