[Pubmed] Comparative Study of Sporadic and Immune Checkpoint Inhibitor-Related Forms of Myasthenia Gravis-Myositis Overl

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Neurology. 2026 Jun 23;106(12):e218081. doi: 10.1212/WNL.0000000000218081. Epub 2026 May 26.

ABSTRACT

BACKGROUND AND OBJECTIVES: Myasthenia gravis-inflammatory myopathy (MG-IM) overlap syndrome can occur as an immune-related adverse event (irAE) after immune checkpoint inhibitor (ICI) therapy. Before the advent of ICIs, a sporadic form of MG-IM (s-MG-IM), often thymoma-associated, was already described. This study compared clinical and serologic features, treatment strategies, and outcomes of s-MG-IM and ICI-related MG-IM (ir-MG-IM).

METHODS: We conducted a multicenter, retrospective cohort study across 8 Italian centers, including consecutive patients fulfilling established criteria for both MG and IM, with or without previous exposure to ICIs. Clinical features, antibody profiles, oncologic history, treatments, and outcomes were collected and compared. Available serum samples were tested for binding capacity and pathogenic properties (antigenic modulation and complement-activating capacity) against clustered adult (A) and fetal (F) AChR isoforms using a live cell-based assay (L-CBA).

RESULTS: Thirty-eight patients were identified (19 with s-MG-IM and 19 with ir-MG-IM). The ir-MG-IM cohort was older (median 77 vs 59 years, p

Source: https://pubmed.ncbi.nlm.nih.gov/4219014 ... 0&v=2.20.0