Prednisone and Cyclosporine A are used for long-term immunosuppression when further benefit is needed and relatively rapid onset of benefit is desired. Azathioprine provides long-term immunosuppression with relatively few side effects. However, it has a long latency before benefit begins, and some patients do not improve at all. Mycophenolate mofetil may be a useful substitute for azathioprine with fewer side effects and a shorter latency of action.
More experience is required.
Human immune globulin are used when MG patients have life-threatening signs such as respiratory insufficiency or dysphagia and a very rapid response to treatment is desired. PE is preferred.