CAR T Therapy Likely the Next Frontier for Treating Patients With MG: James F. Howard, MD

CAR-T therapies could be the “next frontier” for treating myasthenia gravis (MG), said James F. Howard, MD, professor of neurology at UNC School of Medicine.

When discussing the future of treatment for MG, Howard emphasized how the past decade has seen a revolution in treatment for MG, starting with an FDA approval in 2017 that gave doctors their first-ever treatment for generalized MG. Now, there are 7 approved therapies for MG that are available for patients and clinicians alike.

“We are now, I won’t say rich with treatment, but clearly much farther along than we had ever been,” said Howard.

As researchers continue to focus on this area of treatment, Howard believes that the next frontier will be in CAR T-cell therapy. The therapy can be based on either DNA or mRNA. mRNA, he said, is likely the one to catch hold, as trials are currently underway to test the efficacy of such treatments and will have much more narrow adverse effect profiles.

Researchers are also looking into other treatments that target different parts of the immune system, said Howard. This can include treatments that replace the cholinesterase inhibitor class. The next decade should see even more therapeutics coming out.

“Why do we need new therapeutics? People say, don’t you have enough already? And it's interesting when you look at clinical trials…on average 32% of [participants in the blinded phase] do not respond to that drug,” Howard explained. New treatments are able to give clinicians and patients options. If they do not respond to one drug, they can switch to a different one to help treat their condition.

Overall, the future of treating MG is looking positive, and new treatments could help patients living with MG by giving them multiple options in case of a lack of response after initial treatment.