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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How can myasthenia gravis be treated?

I was diagnosed with Myathenia Grevis about 18 years ago, becoming totally paralized. once they had done plasma pherisus and I was gaining use of my muscles again, they put me on Prednisone, Mestinon and cyclosporin, eventually weining me off the Prednisone. I have just recently had a relapce and my present Dr. has put me on the same meds, starting with 20 MG. Prednison, ramping up to 100 MG. at a rate of 5 MG. every five days; 300 MG. cyclosporine; and the 120 MG. Mestinone I had been taking. Now, her intent is to eventually get me off the Prednisone and Mestinone completely and only be taking Cyclosporine. This does not seem to be the right end game here. Is it?
Tue, 8 May 2018
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General & Family Physician 's  Response
Hello and Welcome to ‘Ask A Doctor’ service.
I have reviewed your query and here is my advice.
     
Myasthenia gravis is an autoimmune disease and drugs that suppress our immune system helps a lot. Steroids are very effective in controlling the symptoms. Cyclosporine and other immunosuppressive medicines take some time to start working. However, prolonged use of steroids is not very safe so what we do is to use it for a limited time, until other drugs like Cyclosporine starts working. This is the plan for most of the diseases that are autoimmune. So your plan is a very good one.

You should try to use the minimum drug that controls your disease. For many people, only Cyclosporine will suffice with on and off the use of steroids in between when needed (or when serious then plasmapheresis or immunoglobulin). So it's better that your drugs are reduced to the minimum level. You must not worry as any time you feel your doctor can increase it again. But we should give it a trial.

Hope I have answered your query. Let me know if I can assist you further.

Regards,      
Dr. Mahboob Ur Rahman

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How can myasthenia gravis be treated?

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Myasthenia gravis is an autoimmune disease and drugs that suppress our immune system helps a lot. Steroids are very effective in controlling the symptoms. Cyclosporine and other immunosuppressive medicines take some time to start working. However, prolonged use of steroids is not very safe so what we do is to use it for a limited time, until other drugs like Cyclosporine starts working. This is the plan for most of the diseases that are autoimmune. So your plan is a very good one. You should try to use the minimum drug that controls your disease. For many people, only Cyclosporine will suffice with on and off the use of steroids in between when needed (or when serious then plasmapheresis or immunoglobulin). So it s better that your drugs are reduced to the minimum level. You must not worry as any time you feel your doctor can increase it again. But we should give it a trial. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Mahboob Ur Rahman