Myasthenia Gravis
Your patients' symptoms change by the hour. Your data collection doesn't.
Myasthenia gravis is defined by fluctuation — weakness that worsens with activity, improves with rest, and shifts unpredictably across muscle groups throughout the day. Clinic visits capture a single snapshot. Forma captures the full picture.
Forecast
Based on prior Topics logging
Topics
How it works
15 seconds of speech. 25 data points.
Forma turns each patient into a continuous data stream. By voice or text, patients log what's happening in the moment — fatigable weakness, bulbar safety events, infusion responses, breathing changes — in 20 seconds. No forms, no recall bias. The result is structured, longitudinal data across every MG domain, paired with the clinical assessments you already collect.
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Forecast
Based on prior Topics logging
Topics
Structured, coded, longitudinal
- Timing
- Onset time:10:00 AMTrigger duration:30 min
- Location
- Ptosis location:Bilateral eyelids
- Severity
- Symptom:DiplopiaPtosis:PresentBulbar symptom:Chewing difficulty
- Actions
- Trigger activity:Sustained readingMedication:PyridostigmineDose:60 mg
- Environmental
- Barometric pressure:30.12 inHg (steady)
- Outcome
- Response time:Within 1 hour
From data to insights
What the data reveals
Daily voice logs compound into actionable insights — for patients managing their condition and for researchers running studies.
For Patients
When in my Vyvgart cycle do I feel best?
Your peak improvement hits days 12–18 of each cycle — arms recover first, then swallowing, then speech. By day 22 symptoms start returning. This cycle you had 6 consecutive choking-free days (days 13–18), your best stretch in 4 months.
Symptom severity
How dangerous are my choking episodes?
You had 4 choking events this month, all between days 1–5 of your cycle when IgG levels are highest. Three were on thin liquids, one on solid food. None required intervention, but the pattern suggests thickened liquids during the first week of each cycle would reduce risk.
Choking by cycle day
Is my weakness getting better overall?
Comparing your last 3 Vyvgart cycles: arm endurance improved from 4 minutes to 11 minutes for overhead tasks. Your worst-day MG-ADL dropped from 18 to 12. Best-day scores are stable at 4. The floor is rising — your bad days are less bad.
Worst-day MG-ADL
Summarize this cycle for my neurologist.
Cycle 6 complete. MG-ADL range: 4–14 (baseline was 6–18). Choking episodes: 4, all week 1. Arms: laundry-capable by day 10 (was day 14 last cycle). Speech: clear days 11–25. FVC stable at 2.4L. Mestinon cramps day 7 — resolved. No crisis indicators.
For Researchers
What is the real-world Vyvgart response curve?
Across 29 gMG patients, MG-ADL improvement onset: median day 8 (IQR 5–12). Peak response: days 14–21. Bulbar domains improve 3 days after limb domains. 68% achieve clinically meaningful improvement (≥2-point MG-ADL drop) by cycle 2. Daily data reveals the response is not linear — it follows a sigmoid curve invisible to monthly scoring.
MG-ADL by cycle week
Trend
How often do bulbar safety events occur between visits?
Choking episodes average 3.2/month in our cohort — 89% unreported at clinic visits. 72% cluster in the first week of biologic cycles when antibody levels rebound. Aspiration-risk events (coughing on thin liquids + nasal regurgitation) predict crisis within 14 days with 78% sensitivity.
Events by cycle week
Trend
Can daily data predict myasthenic crisis?
FVC decline >20% over 7 days preceded crisis in 4 of 4 events in our cohort. Speech capacity dropping below 4 words/breath adds specificity. Combined with rising MG-ADL scores >3 points/week, this algorithm flags crisis risk 5–8 days before ER presentation.
Pre-crisis trajectory
Trend
How does fatigue differ from weakness in MG?
Daily logging separates generalized fatigue (present in 91% of patient-days) from specific muscle fatigability (67% of patient-days). Fatigue correlates with sleep quality (r=0.58) while fatigability correlates with activity level (r=0.71). Biologic responders show faster fatigability improvement but fatigue often persists — important for PRO endpoint selection.
Fatigue vs. weakness
Trend
Arms gave out folding laundry. Eyelid droop starting in the evening. Speech slightly nasal.
Choked on water at dinner. Switched to thickened liquids. Double vision in the evening.
Fatigue hit hard — cancelled plans, two naps. Swallowing back to normal.
Week 1 Vyvgart infusion. Mild headache after — 3/10. Otherwise fine.
Slightly better after infusion. Managed to work 3 hours. Eyelid droop only after reading.
Good day — ate a normal dinner, no choking. Mestinon causing some cramping.
Week 2 Vyvgart infusion. No reactions. Already feeling noticeably stronger.
Best day in weeks. Folded laundry, did dishes, styled hair without stopping. No choking at all.
Week 3 — usually the best week. Speech clear, swallowing normal, arms strong.
Starting to feel the cycle wearing off. Arms slightly weaker, eyelid droop returning.
Final week 4 infusion. Cycle complete. Bulbar symptoms have improved dramatically over the month.
Key insight
Over one Vyvgart cycle, Sarah's daily logs reveal what clinic visits cannot: arms improving from score 2 to 0 by week 3, a choking episode on day 2 that triggered a safety flag, and the visible correlation between infusion timing and functional recovery. This is the data that turns a quarterly MG-ADL score into a continuous treatment response curve.
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