Telitacicept in combination with B-cell depletion therapy in MuSK antibody-positive myasthenia gravis: a case report and literature review

Front Immunol. 2024 Nov 18:15:1456822. doi: 10.3389/fimmu.2024.1456822. eCollection 2024.

Abstract

Muscle-specific kinase (MuSK) myasthenia gravis (MG) is relatively rare and has a higher incidence of myasthenic crisis compared with other subtypes. However, there is still a lack of effective treatment for refractory MuSK MG. We report the case of a 70-year-old female MuSK MG patient with recurrent fluctuations who stabilized on telitacicept in combination with anti-CD20 B-cell depletion therapy. This combination regimen deserves further investigation. Furthermore, we summarized the treatment protocols of 14 previously reported cases of MuSK MG.

Keywords: B-cell depletion therapy; case report; muscle-specific tyrosine kinase; myasthenia gravis; telitacicept.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Autoantibodies* / blood
  • Autoantibodies* / immunology
  • B-Lymphocytes* / immunology
  • Female
  • Humans
  • Lymphocyte Depletion*
  • Myasthenia Gravis* / diagnosis
  • Myasthenia Gravis* / drug therapy
  • Myasthenia Gravis* / immunology
  • Myasthenia Gravis* / therapy
  • Receptor Protein-Tyrosine Kinases* / immunology
  • Receptors, Cholinergic* / immunology
  • Rituximab / therapeutic use
  • Treatment Outcome

Substances

  • MUSK protein, human
  • Receptors, Cholinergic
  • Receptor Protein-Tyrosine Kinases
  • Autoantibodies
  • Rituximab

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Sanming Project of Medicine in Shenzhen (grant numbers SZZYSM202111011); Traditional Chinese Medicine Bureau of Guangdong Province (grant numbers 20221357); “3030 project” of Clinical Research Program in Shenzhen Traditional Chinese Medicine Hospital in 2021 (grant numbers G3030202132).