Neurology® Podcast Trends and Disparities in the Utilization of Thymectomy for MG in the US
Mar 31, 2025
Dr. Jennifer Morganroth, a Neuromuscular and EMG fellow at Columbia, discusses the dramatic increase in thymectomy procedures for myasthenia gravis since the groundbreaking MGTX trial in 2016. She highlights significant disparities in access to these surgeries, especially among African-American patients and women. The conversation also delves into the impact of hospital characteristics and patient communication on treatment availability. Moreover, they explore the shift towards minimally invasive surgical techniques and the implications of new non-surgical treatments for future practices.
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MGTX Trial Validates Thymectomy
- The 2016 MGTX trial was the first definitive evidence supporting thymectomy benefit in acetylcholine receptor antibody-positive myasthenia gravis.
- It showed reduced steroid needs, symptom severity, and hospitalizations compared to prednisone alone.
Thymectomy Use Dramatically Increased
- Thymectomy procedures for myasthenia gravis increased sharply in the US after the MGTX trial publication.
- Numbers grew from 45 in 2012 to 1,150 in 2019, showing adoption of evidence into practice.
New Therapies May Change Thymectomy Use
- Despite increased thymectomy rates post-MGTX, evolving immunosuppressive therapies might reduce future surgical rates.
- Newer non-surgical treatments could lower the need for thymectomy over time.