Therapeutic Paradigm Changes in Myasthenia Gravis and Amyotrophic Lateral Sclerosis

Oh, Seong-il

doi:2026.44.2.124

J Korean Neurol Assoc > Volume 44(2); 2026 > Article

Review Article

Journal of the Korean Neurological Association 2026;44(2): 124-133. doi: https://doi.org/10.17340/jkna.2025.0062

중증근무력증과 근위축측삭경화증에서의 치료 패러다임 전환

오성일

경희대학교 의과대학 경희대학교병원 신경과

Therapeutic Paradigm Changes in Myasthenia Gravis and Amyotrophic Lateral Sclerosis

Seong-il Oh MD, PhD

Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea

Corresponding Author: Seong-il Oh ,Tel: +82-2-958-8499, Fax: +82-2-958-8490, Email: ohsi@khu.ac.kr

*These authors contributed equally to this work

Received: December 30, 2025 Revised: February 27, 2026 Accepted: March 3, 2026 Published online: May 1, 2026

Abstract

The treatment paradigm for neuromuscular diseases, especially myasthenia gravis and amyotrophic lateral sclerosis, has recently shifted with the emergence of mechanism-based and precision therapies. In myasthenia gravis, improved understanding of antibody-mediated pathology has enabled the clinical adoption of targeted immunotherapies, including complement inhibitors and neonatal Fc receptor antagonists, resulting in meaningful benefits for refractory disease and a shift beyond conventional immunosuppression. In amyotrophic lateral sclerosis, while multidisciplinary care remains fundamental, recent advances highlight a gradual move toward precision medicine through platform trial designs, biomarker-informed evaluation, and gene-specific molecular therapies for selected patient subgroups. Together, these developments reflect a paradigm shift from uniform treatment strategies to individualized, pathophysiology-driven clinical decision-making. This review summarizes recent guideline updates and key clinical trial evidence, illustrating how advances in immunopathology, genetics, and trial methodology are redefining contemporary neuromuscular care.

Key Words: Neuromuscular diseases | Myasthenia gravis | Amyotrophic lateral sclerosis | Precision medicine | Targeted immunotherapy