What is the Myasthenia Gravis Composite Scale?
The Myasthenia Gravis Composite Scale is not mentioned or defined in the available clinical guidelines and evidence for myasthenia gravis management. The provided evidence does not contain information about this specific assessment tool.
Assessment Tools Actually Referenced in Guidelines
The guidelines reference different classification and scoring systems for myasthenia gravis:
Myasthenia Gravis Foundation of America (MGFA) Classification
- MGFA Class 1: Ocular symptoms and findings only 1
- MGFA Class 2: Mild generalized weakness 1
- MGFA Class 3-4: Moderate to severe generalized weakness to myasthenic crisis 1
This classification system is used to guide treatment decisions, particularly in determining when to hold versus permanently discontinue immune checkpoint inhibitors and when to escalate therapy 1.
Other Assessment Tools Mentioned
- Myasthenia Gravis Activities of Daily Living (MG-ADL): Used for disease activity assessment 2
- Quantitative Myasthenia Gravis (QMG): Used for disease activity assessment 2
Clinical Grading Used in Guidelines
The ASCO guidelines use a functional grading system 1:
- Grade 2: Some symptoms interfering with activities of daily living 1
- Grade 3-4: Limiting self-care, aids warranted, weakness limiting walking, any dysphagia, facial weakness, respiratory muscle weakness, or rapidly progressive symptoms 1
Why Disease Activity Assessment Matters
Modern treatment algorithms require accurate measurement of disease activity to determine when to escalate from standard therapies (pyridostigmine, corticosteroids, azathioprine) to newer immunomodulators like complement inhibitors or FcRn modulators 2. The assessment must evaluate clinical course severity and required therapies to differentiate between mild/moderate and highly active or refractory disease 2.