MG is an uncommon disease. Incidence has been reported as between 3 and 28 cases per million per year, with an estimated 10 to 20 cases per million per year in the US.[1]Sanders DB, Wolfe GI, Benatar M, et al. International consensus guidance for management of myasthenia gravis: executive summary. Neurology. 2016 Jul 26;87(4):419-25.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4977114
http://www.ncbi.nlm.nih.gov/pubmed/27358333?tool=bestpractice.com
[30]Phillips LH. The epidemiology of myasthenia gravis. Semin Neurol. 2004 Mar;24(1):17-20.
http://www.ncbi.nlm.nih.gov/pubmed/15229788?tool=bestpractice.com
[31]Deenen JC, Horlings CG, Verschuuren JJ, et al. The epidemiology of neuromuscular disorders: a comprehensive overview of the literature. J Neuromuscul Dis. 2015;2(1):73-85.
http://www.ncbi.nlm.nih.gov/pubmed/28198707?tool=bestpractice.com
The worldwide prevalence has been estimated as 12.4 people per 100,000 population (a total of around 700,000 cases).[1]Sanders DB, Wolfe GI, Benatar M, et al. International consensus guidance for management of myasthenia gravis: executive summary. Neurology. 2016 Jul 26;87(4):419-25.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4977114
http://www.ncbi.nlm.nih.gov/pubmed/27358333?tool=bestpractice.com
[31]Deenen JC, Horlings CG, Verschuuren JJ, et al. The epidemiology of neuromuscular disorders: a comprehensive overview of the literature. J Neuromuscul Dis. 2015;2(1):73-85.
http://www.ncbi.nlm.nih.gov/pubmed/28198707?tool=bestpractice.com
[32]Salari N, Fatahi B, Bartina Y, et al. Global prevalence of myasthenia gravis and the effectiveness of common drugs in its treatment: a systematic review and meta-analysis. J Transl Med. 2021 Dec 20;19(1):516.
https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-021-03185-7
http://www.ncbi.nlm.nih.gov/pubmed/34930325?tool=bestpractice.com
A Norwegian cohort study reported an annual incidence rate of 8.8 to 16 per million, and prevalence of 131 to 145 per million.[33]Andersen JB, Heldal AT, Engeland A, et al. Myasthenia gravis epidemiology in a national cohort; combining multiple disease registries. Acta Neurol Scand Suppl. 2014;(198):26-31.
http://onlinelibrary.wiley.com/doi/10.1111/ane.12233/full
http://www.ncbi.nlm.nih.gov/pubmed/24588503?tool=bestpractice.com
Epidemiological data from northern Portugal suggested an MG incidence rate of 6.3 per million per year and a point prevalence of 111.7 per million.[34]Santos E, Coutinho E, Moreira I, et al. Epidemiology of myasthenia gravis in Northern Portugal: Frequency estimates and clinical epidemiological distribution of cases. Muscle Nerve. 2016 Sep;54(3):413-21.
http://www.ncbi.nlm.nih.gov/pubmed/26851892?tool=bestpractice.com
The highest prevalence rate was reported in older men (288.1 per million in men aged >65 years).[34]Santos E, Coutinho E, Moreira I, et al. Epidemiology of myasthenia gravis in Northern Portugal: Frequency estimates and clinical epidemiological distribution of cases. Muscle Nerve. 2016 Sep;54(3):413-21.
http://www.ncbi.nlm.nih.gov/pubmed/26851892?tool=bestpractice.com
In South Korea, incidence and prevalence rates of 0.55 per 100,000 person-years and 12.99 per 100,000 people, respectively, were reported in 2014.[35]Lee HS, Lee HS, Shin HY, et al. The epidemiology of myasthenia gravis in Korea. Yonsei Med J. 2016 Mar;57(2):419-25.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4740535
http://www.ncbi.nlm.nih.gov/pubmed/26847295?tool=bestpractice.com
The prevalence of MG appears to be increasing, particularly in developed countries. This may be due, in part, to an ageing population, improved longevity of patients with MG, and availability of more accurate diagnostic tools. In Ontario, Canada, the age- and sex-standardised prevalence rate increased from 16.3 per 100,000 population in 1996 to 26.3 per 100,000 in 2013, but the incidence rate remained stable during this period.[36]Breiner A, Widdifield J, Katzberg HD, et al. Epidemiology of myasthenia gravis in Ontario, Canada. Neuromuscul Disord. 2016 Jan;26(1):41-6.
http://www.ncbi.nlm.nih.gov/pubmed/26573434?tool=bestpractice.com
MG reportedly occurs in all ethnic groups; relative differences in disease prevalence are yet to be determined. One study of ocular MG found that non-white patients tended to present at a younger age.[37]Peragallo JH, Bitrian E, Kupersmith MJ, et al. Relationship between age, gender, and race in patients presenting with myasthenia gravis with only ocular manifestations. J Neuroophthalmol. 2016 Mar;36(1):29-32.
http://www.ncbi.nlm.nih.gov/pubmed/26035808?tool=bestpractice.com
MG is manifest from infancy to old age; more women than men are affected.[31]Deenen JC, Horlings CG, Verschuuren JJ, et al. The epidemiology of neuromuscular disorders: a comprehensive overview of the literature. J Neuromuscul Dis. 2015;2(1):73-85.
http://www.ncbi.nlm.nih.gov/pubmed/28198707?tool=bestpractice.com
The incidence is significantly higher in black women, particularly in the US. Women usually present under the age of 40, whereas men typically develop symptoms later, with a median age of onset in the seventh decade.[36]Breiner A, Widdifield J, Katzberg HD, et al. Epidemiology of myasthenia gravis in Ontario, Canada. Neuromuscul Disord. 2016 Jan;26(1):41-6.
http://www.ncbi.nlm.nih.gov/pubmed/26573434?tool=bestpractice.com
[37]Peragallo JH, Bitrian E, Kupersmith MJ, et al. Relationship between age, gender, and race in patients presenting with myasthenia gravis with only ocular manifestations. J Neuroophthalmol. 2016 Mar;36(1):29-32.
http://www.ncbi.nlm.nih.gov/pubmed/26035808?tool=bestpractice.com
MG characterised by antibodies directed against muscle-specific tyrosine kinase (MuSK) predominantly affects women (between 80% to 90% of patients).