Update for Hospital and Health-System Pharmacists on Newer Therapeutics to Optimize Management of Patients with Generalized Myasthenia Gravis

Provided by AcademicCME

This activity has been supported by an independent educational grant from argenx.

Program Overview

About 85% of patients with generalized myasthenia gravis (gMG)--an autoimmune disease of the neuromuscular junction caused by antibodies that attack components of the postsynaptic membrane, impair neuromuscular transmission, and therefore cause weakness and fatigue of skeletal and bulbar muscles--have demonstrable IgG autoantibodies. These autoantibodies exert a direct pathogenic effect that results in impaired neuromuscular transmission. Most currently available treatments, including corticosteroids and nonsteroidal immunosuppressive therapies, broadly suppress the immune system and do not selectively target those IgG autoantibodies central to generalized myasthenia gravis pathophysiology. In addition, these treatments often provide only limited symptom relief and—especially in the case of steroids—are associated with treatment-limiting side-effects. A new approach that addresses that unmet need involves predictable lowering levels of pathogenic autoantibodies. In MG, the neonatal Fc receptor (FcRn) is a major factor regulating the serum levels of IgG antibodies. While FcRn-mediated half-life extension is beneficial for IgG antibody responses against pathogens, it also prolongs the serum half-life of IgG autoantibodies and thus promotes tissue damage in autoimmune diseases such as MG. A mutated antibody to the FcRn can block that IgG-associated damage and potentially improve outcomes and treatment tolerance in generalized MG. The FDA has now approved drugs that target FcRn-mediated antibody recycling and can improve patient outcomes while reducing the need for corticosteroids. 

Pharmacy professionals play an important role in the new era of recently approved therapeutic options to treat patients with gMG. Whether working in the hospital, in a neuromuscular clinic, or in an infusion center, pharmacists play a key role in supporting patient care, preparing and delivering these medications, and evaluating comorbidities and concomitant medications of interest. It is important for pharmacists involved in the care of patients with gMG to be well-informed about the pathophysiology of gMG, the reason why FcRn-targeted therapy can be beneficial, and about the multiple ways pharmacists can help improve patient comfort, satisfaction, and outcomes with this therapy.

Target Audience

Pharmacists, pharmacy technicians and other healthcare professionals who care for patients with myasthenia gravis

Agenda

1. Generalized Myasthenia Gravis Update: Pathology, Disease Augmentation from Drug Interactions, Concern for Glucocorticoid Toxicity, and Unmet Patient Needs
2. Pharmacology, MOA, and Clinical Trial Data for Newer Therapeutics to Treat gMG
3. Strategies to Improve Outcomes through Patient Education, Addressing Barriers to Care, Minimizing Potential Drug-Drug Interactions, and Optimizing Adherence to Treatment

Learning Objectives

1. Review the pathology, concerns for disease augmentation from other medications, potential for associated glucocorticoid toxicity, and specific unmet needs of patients with gMG
2. Discuss the mechanisms of action, pharmacology, and clinical trial data for current FcRn and complement inhibitor therapeutics to treat gMG
3. Review patient educational needs, updated route of administration, and strategies to minimize potential drug-drug interactions and optimize adherence to treatment

Faculty

Kipp Tiger, PharmD, CSP (Course Chair)
Clinical Pharmacist, Neuroscience
CPS Solutions at Summa Health Specialty
Akron, Ohio

Alexis El-Khouri, PharmD
Clinical Pharmacist, Neuroscience
CPS Solutions at Summa Health Specialty
Akron, Ohio

Claire Spahn, PharmD, BCPS
Clinical Pharmacist, Neuroscience
Stanford Health Care
Palo Alto, California

Disclosures of Relevant Financial Relationships

It is the policy of AcademicCME that all faculty, instructors, and planners disclose relevant financial relationships with ineligible companies. Any relevant financial relationships related to this activity have been mitigated.

Planners and faculty have no relevant financial relationships with ineligible companies for this activity, with the exception of the following:

Planners and Peer Reviewers

Timothy Hayes, MD, PhD; Kim Cheramie, MSN, RN-BC; Nicole McMenamin and Chelsey Simonds hereby state that they or their spouse/life partner do not have any relevant financial relationships to products or devices with any commercial interests related to the content of this activity of any amount during the past 12 months.

Accreditation Statement

In support of improving patient care, AcademicCME is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Credit Designation Statements

AcademicCME designates this continuing education activity for 1.50 CPE Contact Hour (0.15 CEUs) of continuing pharmacy education credit (UAN JA4008190-0000-24-001-H01-P).

Pharmacists should only claim credit commensurate with the extent of their participation.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. AcademicCME and argenx do not recommend the use of any agent outside of the labeled indications.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Method of Participation

In order to claim credit, participants must complete the following:

1. Read the learning objectives, accreditation information and faculty disclosures at the beginning of this activity.
2. Complete the Pre-Activity Questions.
3. Read or Review the activity content.
4. Complete the Post-Activity Test Questions and Evaluation.
5. Learners who receive a grade of 66% or better on the Post-Activity Test Questions and complete the Evaluation will receive CPE credit. CPE credit will be posted to the learner's CPE Monitor profile within 60 days of completion. 

CE Inquiries/Special Needs

For all CPE inquiries or special needs, please contact admin@academiccme.com.