Does change in acetylcholine receptor antibody level correlate with clinical change in myasthenia gravis?

Muscle Nerve. 2014 Apr;49(4):483-6. doi: 10.1002/mus.23944.


Introduction: The objective of this study is to determine if change in acetylcholine receptor antibody (AChR-ab) levels reflects change in clinical severity in patients with myasthenia gravis (MG).

Methods: We reviewed results from a prospective trial in MG and from all 85 patients in an MG Clinic who had AChR-ab determinations performed at least twice by the same commercial laboratory.

Results: Change in AChR-ab levels correlated only weakly with change in clinical severity. AChR-ab levels fell in 92% of patients who improved and in 63% who did not. A fall in AChR-ab level had a positive predictive value for clinical improvement of 83% and a negative predictive value of only 59%.

Conclusions: AChR-ab levels fell in almost all patients who improved, but also in most patients who did not. Thus, we do not recommend commercially available AChR-ab levels as a biomarker of improvement in MG. However, antibody levels might be useful as a marker for inadequate immunotherapy.

Keywords: MG Composite; QMG score; acetylcholine receptor antibody; clinical trials; myasthenia gravis; outcome measures.

Publication types

  • Clinical Trial

MeSH terms

  • Autoantibodies / blood*
  • Biomarkers / blood
  • Cohort Studies
  • Databases, Factual / trends
  • Humans
  • Myasthenia Gravis / blood*
  • Myasthenia Gravis / diagnosis*
  • Myasthenia Gravis / therapy
  • Prospective Studies
  • Receptors, Cholinergic / blood*
  • Registries


  • Autoantibodies
  • Biomarkers
  • Receptors, Cholinergic