Covid-19: Children’s mental health services in England are “nowhere near sufficient,” says commissioner

Myasthenia gravis (MG) is a chronic autoimmune disorder of the neuromuscular junction characterised by an autoantibody against acetylcholine receptor (AChR-Ab), muscle-specific kinase (MuSK-Ab), lipoprotein-related protein 4 or agrin in postsynaptic membrane at junction. Many patients are resistant to conventional treatment and effective therapies needed. Rituximab (RTX) monoclonal antibody directed CD20 antigen on B cells which has been successfully employed anti-MuSK-Ab+MG, but efficacy anti-AChR-Ab+MG still debated. The purpose this systematic review was describe best evidence for RTX subtype. authors undertook literature search during period 1999–2019 according Preferred Reporting Items Systematic Reviews Meta-Analys methodology, employing (myasthenia)+(gravis)+(RTX) as terms. analysis confined studies that include least five with confirmed anti-AChR-Ab+MG. Thirteen have selected, showing good safety. data obtained were heterogeneous terms posology, administration scheme patients’ evaluation, ranging from minimum two maximum three cycles. led sustained clinical improvement prolonged time relapse, parallel reduction discontinuation other immunosuppressive therapies. Treatment appears work some not all anti-AChR-Ab+MG, randomised controlled trials Future should take into account subtype MG employ reliable measures outcome severity focusing how identify who may benefit treatment. Trial registration number: NCT02110706.