To comprehensively understand the patient profile of individuals with myasthenia gravis (MG) by describing demographics, clinical characteristics, and treatment patterns from a large US health claims database.

MG is a rare autoimmune disorder of the neuromuscular junction leading to debilitating fatigable muscle weakness.

This was a retrospective, non-interventional, real-world descriptive analysis of data from the Optum Clinformatics^® Data Mart. Adults (≥18 years) diagnosed with MG using ≥2 ICD-9 and -10 codes between 1 January 2011 and 31 December 2022, and with continuous enrolment for 12 months before MG diagnosis were included. The index date was the first MG diagnosis or first prescription for pyridostigmine within 30 days before the first diagnosis. Demographics, clinical characteristics, and treatment patterns in the post-index period are reported. 

In total, 12,322 patients were identified: mean age was 68.4 (SD±14.1) years, 50.5% were female, and 70.4% had Medicare cover. The median follow-up duration was 991 (IQR: 487–1846) days. Generalized symptoms occurred in 62.0% of patients: fatigue (28.7%), dysphagia (27.5%), muscle weakness (25.6%), and dyspnea (24.3%). Nearly a third of patients (32.0%) had a Charlson Comorbidity Index score of ≥3. Patients initiating treatment within 180 days of diagnosis (57.4%) most commonly took acetylcholinesterase inhibitors (AChEi, 55.8%) or oral corticosteroids (OCS)/OCS+AChEi (33.1%); of these, 48.2% switched to a second-line treatment within 90 days following discontinuation of prior treatment. Thirty percent received no treatment in the post-index period. Overall, 47.5% received OCS; of these, 71.3% received >20 mg/day and 54.6% received ≥40 mg/day. In total, 7.9% had refractory MG based on strictly defined criteria. MG crisis and exacerbations occurred in 6.7% and 48.5% of patients, which averaged 1.9 and 5.3 per patient, respectively.

This retrospective claims-based study provides a comprehensive real-world characterization of patients with MG in the US, leveraging data from over 12,000 individuals across a 13-year period.