Japanese clinical guidelines for myasthenia gravis: Putting into practice

Treatment of myasthenia gravis has depended largely on high-dose corticosteroids for decades. Although this procedure remarkably reduced the mortality rate of myasthenia gravis, it highlighted issues such as the adverse-effects of steroids and reduction in quality of life. With the recent discovery of novel autoantibodies, a numbers of alternative therapeutic options have become available. The new Japanese clinical guidelines for myasthenia gravis were published in 2014, and they proposed a novel treatment strategy utilizing these therapeutic options, which might replace high-dose steroids. They also proposed a draft of new diagnostic criteria. The present review introduces the essence of these guidelines and shares the fundamental philosophy of the treatments that value the patients' quality of life.