See Martinez-Martinez et al. (doi:) for a scientific commentary on this article.Carvajal-González et al. describe the first prospective cohort of patients with glycine receptor antibodies. The majority have progressive encephalomyelitis with rigidity and myoclonus. The antibodies bind to extracellular determinants on glycine receptor-α1 and to glycine receptors on spinal cord and brainstem neurons. The patients make a good recovery with immunotherapies.
IMPORTANCE Use of biologic agents in generalized myasthenia gravis is generally limited to therapy-refractory cases; benefit in new-onset disease is unknown. OBJECTIVE To assess rituximab in refractory and new-onset generalized myasthenia gravis and rituximab vs conventional immunotherapy in new-onset disease.
DESIGN, SETTING, AND PARTICIPANTSA retrospective cohort study with prospectively collected data was conducted on a county-based community sample at
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