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Article History

Received: 6 December 2021

Accepted: 29 March 2022

First Online: 12 April 2022

Declarations

:

: The study was approved by the local ethics committee and institutional review boards (no. AZ 2020-010-f-S, no. AZ 07/2017, 19-8973-BO, AZ 21-1265, AZ 21-1331). Data were anonymized and collected retrospectively according to the standardized requirements of the German register for myasthenia.

: Not applicable.

: Dr. Nelke reports no disclosures. Dr. Stascheit received speaking Honoria from Biogen and Alexion. Cand. med. Eckert reports no disclosures. Dr. Pawlitzki received speaker honoraria and travel/accommodation/meeting expenses from Novartis. Dr. Mergenthaler is on the Advisory Board of HealthNextGen Inc. and has equity interest in the company. His research is funded by the Bundesministerium für Bildung und Forschung (BMBF), the European Union, the Else Kröner-Fresenius Stiftung, the Volkswagen Stiftung, and the Einstein Foundation Berlin. Dr Schroeter reports no disclosures. Dr. Arat reports no disclosures. Dr. Özturk reports no disclosures. Prof. Föll reports no disclosures. Prof. Schreiber reports no disclosures. Prof. Vielhaber reports no disclosures. Dr. Gassa reports no disclosures. Dr. Stetefeld reports not disclosures. Prof. Schroeter reports no disclosures. Dr. Berger received travel grants and/or training expenses from Bayer Vital GmbH, IpsenPharma GmbH, Norvartis, Biogen GmbH and Genzyme, as well as lecture fees from Ipsen Pharma GmbH, Alexion Pharma GmbH, Merck, Sanofi Genzyme and Roche. Dr. Totzeck reports no disclosures. Dr. Hagenacker received speaker and advisory board honoraria from Alexion, Biogen and Roche. Prof. Meuth receives honoraria for lecturing, and travel expenses for attending meetings from Almirall, Amicus Therapeutics Germany, Bayer Health Care, Biogen, Celgene, Diamed, Genzyme, MedDay Pharmaceuticals, Merck Serono, Novartis, Novo Nordisk, ONO Pharma, Roche, Sanofi-Aventis, Chugai Pharma, QuintilesIMS and Teva. His research is funded by the German Ministry for Education and Research (BMBF), Bundesinstitut für Risikobewertung (BfR), Deutsche Forschungsgemeinschaft (DFG), Deutsche Multiple Sklerose Gesellschaft (DMSG), Else Kröner Fresenius Foundation, Gemeinsamer Bundesausschuss (G-BA), German Academic Exchange Service, Hertie Foundation, Interdisciplinary Center for Clinical Studies (IZKF) Muenster, German Foundation Neurology and Alexion, Almirall, Amicus Therapeutics Germany, Biogen, Diamed, Fresenius Medical Care, Genzyme, HERZ Burgdorf, Merck Serono, Novartis, ONO Pharma, Roche, and Teva. Prof. Wiendl receives honoraria for acting as a member of Scientific Advisory Boards, Biogen, Evgen, Genzyme, MedDay Pharmaceuticals, Merck Serono, Novartis, Roche Pharma AG, and Sanofi-Aventis as well as speaker honoraria and travel support from Alexion, Biogen, Cognomed, F. Hoffmann-La Roche Ltd., Gemeinnützige Hertie-Stiftung, Merck Serono, Novartis, Roche Pharma AG, Genzyme, TEVA, and WebMD Global. Prof. Wiendl is acting as a paid consultant for Abbvie, Actelion, Biogen, IGES, Johnson & Johnson, Novartis, Roche, Sanofi-Aventis, and the Swiss Multiple Sclerosis Society. His research is funded by the German Ministry for Education and Research (BMBF), Deutsche Forschungsgemeinschaft (DFG), Else Kröner Fresenius Foundation, Fresenius Foundation, the European Union, Hertie Foundation, NRW Ministry of Education and Research, Interdisciplinary Center for Clinical Studies (IZKF) Muenster and RE Children’s Foundation, Biogen, GlaxoSmithKline GmbH, Roche Pharma AG, Sanofi-Genzyme. Prof. Meisel received speaker honoraria from Alexion, argnx, GRIFOLS and Hormosan. He received honoraria from Alexion, argnx, UCB, Janssen and Vitaccess for consulting services and financial research support from Octapharma and Alexion. Andreas Meisel is chairman of the medical advisory board of the German Myasthenia Gravis Society. Dr. Ruck reports grants from German Ministry of Education, Science, Research and Technology, grants and personal fees from Sanofi-Genzyme and Alexion; personal fees from Biogen, Roche and Teva; personal fees and nonfinancial support from Merck Serono, outside the submitted work.