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CRITERIA

Eligibility

Ages Eligible for Study: at least 18 but less than 60 years, Genders Eligible for Study: Both

Inclusion Criteria:

• Male and female MG patients at least 18 but less than 60 years of age
  
  
• Onset of generalized MG within the last 3 years
  
  
• Positive serum anti-acetylcholine receptor binding antibodies (AchR Ab =/> 1.0 nmol/L)
  
  
• MGFA class II-IV at entry, using the MG Foundation of America (MGFA) classification, while receiving optimal anti-cholinesterase treatment with or without oral prednisone

Exclusion Criteria:

• Concurrent or history of significant neurologic, cardiac, hepatic, pulmonary or renal disease that would be a contraindication to ETTX or interfere with the trial treatments or subsequent clinical assessments.
  
  
• Immunosuppressive therapy with Rituximab at any time; other immunosuppressive therapies (except corticosteroids, plasma exchange and IVIg) in the preceding year
  
  
• Ocular MG without generalized weakness (MGFA Class I) or minimal weakness that would not require the use of corticosteroids
  
  
• Myasthenic weakness requiring intubation (MGFA Class V) in the prior month
  
  
• Immunosuppressive therapy other than corticosteroids in the preceding year
  
  
• Medically unfit for thymectomy
  
  
• Chest CT evidence of thymoma
  
  
• Pregnancy or lactation; contraindications to the use of corticosteroids, unless postmenopausal or surgically sterile. Women considering becoming pregnant during the period of the study are to be excluded.
  
  
• A serious concurrent medical, neurological or psychiatric condition that would interfere with thymectomy or subsequent clinical assessments
  
  
• Current alternate day dose of prednisone > than 1.5 mg/kg or 100 mg or the equivalent daily doses (> 0.75 mg/kg or 50 mg).
  
  
• Participation in another experimental clinical trial
  
  
• History of alcohol or drug abuse within the 2 years prior to randomization.

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