LEMS TREATMENT
GOALS OF LEMS
THERAPYShareCopy LinkCOPIED!
There is currently no cure for Lambert-Eaton myasthenic syndrome (LEMS); however, there are treatments available that can significantly reduce the impact of LEMS on patients’ lives.12,25
In general, the goals for LEMS treatment include3,12,25,29:
- Relief of autonomic symptoms
- Restoration/maintenance of muscle function and strength
- Improved patient mobility and independence
- Improved quality of life
- Assessing for/treating associated malignancies
LEMS Treatment CategoriesShareCopy LinkCOPIED!
Antitumor Therapy
- Essential for all patients with paraneoplastic LEMS29
- Limited data suggest some patients may experience improvement in LEMS symptoms following antitumor therapy30,31
Immunotherapy
- Recommended for flares or when symptomatic treatment is not sufficient29
- Limited clinical data suggest that oral and infusion immunosuppressive therapies can provide short-term benefit for adult patients with LEMS32
Neuromuscular Junction Modulation
- Increase neuromuscular transmission of acetylcholine (ACh) (amifampridine) or inhibit degradation of ACh (pyridostigmine)29
- Clinical data suggest that cholinesterase inhibitors, such as pyridostigmine, are generally not effective as monotherapies for LEMS25,33
- In a double-blind, randomized controlled trial comparing the efficacy of 3,4-DAP and pyridostigmine in LEMS, only 3,4-DAP produced significant improvements in muscle strength and compound muscle action potential (CMAP) amplitudes33
- 3,4-DAP is currently recommended as first-line therapy for LEMS34
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