MG-ADL score
Do you see patients like these in your practice?
Patient portrayals
Active professional uncontrolled on an AChE inhibitor and unwilling to consider IV treatment
Busy office worker struggling with recurrence of symptoms with an NSIST and hesitant to change treatments
Recently retired and experiencing symptom exacerbations when tapering prednisone and looking for HCP guidance
New father experiencing breakthrough symptoms despite periodic IVIG
AChE=acetylcholinesterase; AChR=acetylcholine receptor; gMG=generalized myasthenia gravis; HCP=healthcare professional; IVIG=intravenous immunoglobulin; MG-ADL=Myasthenia Gravis Activities of Daily Living; NSIST=nonsteroidal immunosuppressive therapy.
Amber,
33 years old
Active professional uncontrolled on an AChE inhibitor and unwilling to consider IV treatment
Patient portrayal
BACKGROUND
Amber is a real estate agent in a busy firm who loves to travel and explore her city with friends. She was diagnosed with anti-AChR antibody positive gMG 2 years ago and is privately insured.
SYMPTOMS AND CONCERNS
Amber has been experiencing double vision, muscle weakness, and difficulty rising from a sitting position. These symptoms are causing her to miss showings at work, and she recently had to cancel dinner with a couple of friends.
She is frustrated with the impact of her symptoms and eager to explore options to help better manage her gMG. She is resistant to restarting prednisone or considering an IV treatment.
AChE=acetylcholinesterase; AChR=acetylcholine receptor; gMG=generalized myasthenia gravis; MG-ADL=Myasthenia Gravis Activities of Daily Living.
MEDICAL HISTORY
- MG-ADL SCORE: 5
- BMI: 24
- Initially controlled with pyridostigmine and high-dose prednisone; weaned off prednisone without worsening of symptoms
- Thymectomy
CURRENT TREATMENT
- Pyridostigmine 90 mg 4 times a day
AChE=acetylcholinesterase; AChR=acetylcholine receptor; gMG=generalized myasthenia gravis; MG-ADL=Myasthenia Gravis Activities of Daily Living.
Diane, 53 years old
Busy office worker struggling with recurrence of symptoms with an NSIST and hesitant to change treatments
MG-ADL score
Patient portrayal
BACKGROUND
Diane is a medical biller at a suburban practice. She and her husband are active volunteers and members of their church. She was diagnosed with anti-AChR antibody positive gMG 2 years ago and is privately insured.
SYMPTOMS AND CONCERNS
Diane is experiencing increased weakness in her neck, arms, and legs, which makes it hard to sit in front of a computer or attend services and events. She is also experiencing slurred speech and difficulty swallowing and has started to avoid eating lunch with her coworkers.
Diane is worried about the continued effect of her symptoms and is ready to discuss other options. She is concerned that will mean restarting prednisone.
AChR=acetylcholine receptor; gMG=generalized myasthenia gravis; MG-ADL=Myasthenia Gravis Activities of Daily Living; NSIST=nonsteroidal immunosuppressive therapy.
MEDICAL HISTORY
- MG-ADL SCORE: 7
- BMI: 27
- Initially controlled with pyridostigmine and high-dose prednisone, with an attempt to bridge to azathioprine; discontinued azathioprine after 1 year
- Thymectomy
CURRENT TREATMENT
- Pyridostigmine 60 mg 4 times a day
- Mycophenolate mofetil 1.5 g 2 times a day
AChR=acetylcholine receptor; gMG=generalized myasthenia gravis; MG-ADL=Myasthenia Gravis Activities of Daily Living; NSIST=nonsteroidal immunosuppressive therapy.
Hector, 68 years old
Recently retired and experiencing symptom exacerbations when tapering prednisone and looking for HCP guidance
MG-ADL score
Patient portrayal
BACKGROUND
Hector is retired from his job as an accountant and lives with his wife in a semi-suburban area. He was diagnosed with anti-AChR antibody positive gMG 4 years ago and is on Medicare.
SYMPTOMS AND CONCERNS
Hector is experiencing worsening muscle weakness, slurred speech, and occasional double vision after his most recent attempt to taper prednisone. His symptoms recently forced him to cancel some weekend trips with his wife, and he is having trouble keeping up with his usual yard work.
He is feeling increasingly frustrated and self-conscious about his symptoms and is looking to his HCP for guidance about another treatment option. He lives in close proximity to his HCP's office and an infusion center.
AChR=acetylcholine receptor; gMG=generalized myasthenia gravis; HCP=healthcare professional; MG-ADL=Myasthenia Gravis Activities of Daily Living.
MEDICAL HISTORY
- MG-ADL SCORE: 8
- BMI: 29
- Most recent attempt to taper prednisone led to worsening of symptoms; high-dose prednisone was resumed
CURRENT TREATMENT
- Pyridostigmine 60 mg 4 times a day
- Prednisone 40 mg once daily
AChR=acetylcholine receptor; gMG=generalized myasthenia gravis; HCP=healthcare professional; MG-ADL=Myasthenia Gravis Activities of Daily Living.
Matthew, 37 years old
New father experiencing breakthrough symptoms despite periodic IVIG
MG-ADL score
Patient portrayal
BACKGROUND
Matthew is a high school teacher in a small city who recently became a father. He was diagnosed with anti-AChR antibody positive gMG 6 years ago and is privately insured.
SYMPTOMS AND CONCERNS
Matthew is experiencing facial weakness with difficulty smiling and nasality of speech, which makes it hard to interact with students. He is also experiencing limb weakness, which is frustrating to him as it impacts his ability to help his wife care for their daughter, especially in the evenings.
Matthew is concerned about the effect gMG is having on his ability to participate in family activities and the impact on his work from day to day. He is looking for additional options to help manage his symptoms.
AChR=acetylcholine receptor; gMG=generalized myasthenia gravis; IVIG=intravenous immunoglobulin; MG-ADL=Myasthenia Gravis Activities of Daily Living.
MEDICAL HISTORY
- MG-ADL SCORE: 6
- BMI: 26
- Initially controlled with pyridostigmine and high-dose prednisone, which was successfully tapered
- Thymectomy
CURRENT TREATMENT
- Pyridostigmine 60 mg 4 times a day
- Prednisone 20 mg once daily
- Periodic IVIG, with the most recent infusion 4 weeks ago*
*Patients were excluded from the ADAPT clinical trials if they had IVIG or plasma exchange within 1 month of screening.
AChR=acetylcholine receptor; gMG=generalized myasthenia gravis; IVIG=intravenous immunoglobulin; MG-ADL=Myasthenia Gravis Activities of Daily Living.