pyridostigmine Bromide / Generic mfg. - LARVOL DELTA

A case report of sequential efgartigimod and rituximab treatment for tSNMG. (PubMed, Front Immunol) - "After admission, the patient showed poor responses to treatments including pyridostigmine bromide, human immunoglobulin, glucocorticoids, and tacrolimus. Ultimately, following therapy with efgartigimod followed by rituximab, significant symptomatic improvement was observed. By analyzing the diagnosis and treatment process of this case alongside relevant literature, this report explores the therapeutic value of efgartigimod followed by rituximab for tSNMG, key points for individualized regimen adjustments, and the challenges in diagnosis and treatment, thereby providing a reference for the clinical management of such refractory cases."

Journal • CNS Disorders • Immunology • Myasthenia Gravis • Solid Tumor • Thymoma • Thymus Cancer

The Occurrence of Emergence Agitation in Pediatric Strabismus Surgery (clinicaltrials.gov) - P4 | N=76 | Completed | Sponsor: Konkuk University Medical Center | Recruiting ➔ Completed

Trial completion • CNS Disorders • Ophthalmology • Pediatrics • Strabismus

Vagal Stimulation in POTS (clinicaltrials.gov) - P1 | N=11 | Active, not recruiting | Sponsor: Vanderbilt University Medical Center | Trial completion date: Dec 2026 ➔ Dec 2027 | Trial primary completion date: Jun 2026 ➔ Jun 2027

Trial completion date • Trial primary completion date • Cardiovascular

Telitacicept Use in Children With Ocular Myasthenia Gravis: A Case Series Report (ICNMD 2026) - "These children were previously received pyridostigmine bromide, corticosteroids, and nonsteroidal immunosuppressants such as azathioprine and mycophenolate mofetil. Telitacicept demonstrates significant efficacy in improving clinical symptoms of children with OMG and exhibits a relatively good safety profile, which is beneficial in reducing the reliance on corticosteroids and immunosuppressants."

Clinical • CNS Disorders • Myasthenia Gravis

Late emergence of myasthenia gravis complicating envenoming by Vipera ammodytes. (PubMed, Toxicon) - "Although the acute management of snakebite envenomation primarily focuses on life-threatening complications, less severe venom-related effects may be overlooked during this stage. Therefore, long-term monitoring of the patient's clinical status is necessary, with periodic reassessment and adjustment of the therapeutic approach."

Journal • CNS Disorders • Fatigue • Gastrointestinal Disorder • Infectious Disease • Myasthenia Gravis • Pain • Tetanus

An open label, randomized, multiple-dose, two-treatment, two-period, cross-over bioequivalence study comparing Pyridostigmine Bromide, P.R.Tab, 180 mg/tab, VIANEX S.A., Greece versus Mestinon retard 180 mg/prolonged-release tablet, Viatris Healthcare GmbH, Germany, in healthy male and female volunteers under fasting conditions. (clinicaltrialsregister.eu) - P1 | N=44 | Not yet recruiting | Sponsor: Vianex S.A.

New P1 trial • CNS Disorders • Myasthenia Gravis

Cholinergic stimulation after acute myocardial infarction improves hemodynamic parameters and modulates the renal injury in spontaneously hypertensive rats. (PubMed, Sci Rep) - "Thirty adult male SHRs were allocated into three groups (10 animals per group): sham-operated, AMI (infarcted), and AMI + PY (infarcted and treated with the cholinesterase inhibitor pyridostigmine bromide [PY] at 40 mg/kg, administered once daily for seven days)...In addition, treatment reduced plasma creatinine, proteinuria, cell proliferation, and collagen accumulation compared with both AMI and sham groups. These findings indicate that cholinergic stimulation with PY provides cardiac and renal protection by mitigating post-AMI injury and inflammation."

Journal • Preclinical • Anesthesia • Cardiovascular • Inflammation • Myocardial Infarction • Renal Disease

Topical pyridostigmine for ocular myasthenia gravis: a translational hypothesis. (PubMed, Med Hypothesis Discov Innov Ophthalmol) - "Pyridostigmine bromide is a small, hydrophilic quaternary ammonium compound with topical application properties that favor conjunctival permeability while limiting transcorneal penetration...Clinical precedent from alpha-adrenergic eye drops (e.g., apraclonidine) that elevate the eyelid via Müller's muscle support the plausibility of a topical approach...The feasibility of topical or periocular pyridostigmine as a localized treatment strategy for ocular MG deserves further investigation. If validated, this approach could shift management toward targeted, better-tolerated topical therapies with reduced systemic risk."

Journal • CNS Disorders • Immunology • Myasthenia Gravis • Ophthalmology • Strabismus

Individual-Level Factors Associated With 10-Year Incidence of Alzheimer Disease and Related Dementias in the VA Million Veteran Program. (PubMed, Neurology) - "Findings identified TBI, depression, AUD, and MEEs as key variables associated with ADRD in Veterans. These factors may represent important targets for prevention and intervention efforts aimed at improving the long-term health of aging Veterans. Additional work is needed to clarify the mechanisms through which these factors influence ADRD risk and to establish whether observed associations are causal."

Journal • Addiction (Opioid and Alcohol) • Alzheimer's Disease • CNS Disorders • Dementia • Depression • Psychiatry • Vascular Neurology • MVP

Macrophage Immune-Competent Colon Assembloids for Functional Interrogation of Neuroinflammation-Induced Colonic Dysmotility. (PubMed, Gastro Hep Adv) - "Assembloids were allowed to compact and mature, prior to inflammatory insult with pyridostigmine bromide or tumor necrosis factor-alpha...The bioengineered colon assembloid model mimicked diverse aspects of enteric neuroinflammation. Ultimately, the platform offers a physiologically relevant avenue to interrogate neuroimmune crosstalk and dissect mechanisms of colonic dysmotility, paving the way to new therapeutic strategies to improve colonic motility."

Journal • Diabetes • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease • Metabolic Disorders • Oncology • TNFA

An open label, randomized, single-dose, two-treatment, two-period, cross-over bioequivalence study comparing Pyridostigmine Bromide, P.R.Tab, 180 mg/tab, VIANEX S.A., Greece versus Mestinon retard 180 mg/prolonged-release tablet, Viatris Healthcare GmbH, Germany, in healthy male and female volunteers under fed conditions. (clinicaltrialsregister.eu) - P1 | N=44 | Active, not recruiting | Sponsor: Vianex S.A. | Recruiting ➔ Active, not recruiting

Enrollment closed • CNS Disorders • Myasthenia Gravis

The Occurrence of Emergence Agitation in Pediatric Strabismus Surgery (clinicaltrials.gov) - P4 | N=76 | Recruiting | Sponsor: Konkuk University Medical Center | Trial completion date: Aug 2025 ➔ Mar 2026 | Trial primary completion date: Aug 2025 ➔ Mar 2026

Trial completion date • Trial primary completion date • CNS Disorders • Ophthalmology • Pediatrics • Strabismus

An open label, randomized, single-dose, two-treatment, two-period, cross-over bioequivalence study comparing Pyridostigmine Bromide, P.R.Tab, 180 mg/tab, VIANEX S.A., Greece versus Mestinon retard 180 mg/prolonged-release tablet, Viatris Healthcare GmbH, Germany, in healthy male and female volunteers under fasting conditions. (clinicaltrialsregister.eu) - P1 | N=44 | Completed | Sponsor: Vianex S.A.

New P1 trial • CNS Disorders • Myasthenia Gravis

An open label, randomized, single-dose, two-treatment, two-period, cross-over bioequivalence study comparing Pyridostigmine Bromide, P.R.Tab, 180 mg/tab, VIANEX S.A., Greece versus Mestinon retard 180 mg/prolonged-release tablet, Viatris Healthcare GmbH, Germany, in healthy male and female volunteers under fed conditions. (clinicaltrialsregister.eu) - P1 | N=44 | Recruiting | Sponsor: Vianex S.A.

New P1 trial • CNS Disorders • Myasthenia Gravis

Pyridostigmine for the Treatment of Constipation in Parkinson Disease (clinicaltrials.gov) - P2 | N=16 | Recruiting | Sponsor: University of Vermont Medical Center | Trial completion date: Dec 2024 ➔ Dec 2026 | Trial primary completion date: Feb 2024 ➔ Dec 2026

Trial completion date • Trial primary completion date • CNS Disorders • Constipation • Gastroenterology • Gastrointestinal Disorder • Movement Disorders • Parkinson's Disease

Exploring Pembrolizumab-Induced IM3OS in a Patient With Bladder Cancer. (PubMed, Pharmacol Res Perspect) - "The patient was treated with intravenous methylprednisolone, immunoglobulin therapy, and pyridostigmine bromide. This case highlights that pembrolizumab can trigger rare but severe neurological and cardiovascular adverse events. Prompt and thorough investigations to identify syndromes such as myocarditis-myositis-myasthenia gravis overlap syndrome (IM3OS) are vital for timely diagnosis and intervention."

Journal • Bladder Cancer • Cardiovascular • CNS Disorders • Genito-urinary Cancer • Hepatitis C • Immunology • Myasthenia Gravis • Myositis • Oncology • Pain • Solid Tumor • Urothelial Cancer

Modeling Inflammation-Driven Colon Hypertrophy and Motility Changes in Gulf War Illness. (PubMed, bioRxiv) - "Animal models attribute them to pyridostigmine bromide (PB) exposure, which induces smooth muscle hypertrophy, neuroinflammation, and motility impairment...Thus, our model provides a systems-level view of how acute PB-induced inflammation evolves into chronic dysmotility and establishes a first step towards a virtual platform for testing hypotheses and interventions translatable to neuroimmune GI disorders. Neuroinflammation model predicts colon hypertrophy and motility in GWICalibrated to acute (day 7) and chronic (day 30) PB-exposed mouse data Reproduced IL-6 rise, CD40 + persistence, colon thickening, and ChAT/Nos1 shifts Predicted excitatory stress rebound but sustained inhibitory relaxation loss."

IO biomarker • Journal • Gastrointestinal Disorder • Inflammation • CD40 • IL6 • NOS1

TREAT-OMG: TheRapeutic Effect of Different immunosuppressAnts on Non-Thymoma Ocular Myasthenia Gravis: a Real-world Study (clinicaltrials.gov) - P=N/A | N=200 | Recruiting | Sponsor: Tang-Du Hospital | Trial completion date: Nov 2024 ➔ Jun 2026 | Trial primary completion date: Nov 2024 ➔ Apr 2026

Real-world evidence • Trial completion date • Trial primary completion date • CNS Disorders • Myasthenia Gravis • Solid Tumor

Pyridostigmine Attenuated Placental Ischemia-Upregulated Paraventricular Nucleus TLR4-Associated Hypertension in Preeclamptic Rats. (PubMed, Mol Neurobiol) - "PYR significantly reduced MAP in RUPP and LPS-treated dams, as well as TLR4 signaling proteins, ROS, TNF-α, and IL-1β in the PVN. In conclusion, placental ischemia-increased MAP is associated with high TLR4 expression in the PVN and increased TLR4 sensitivity, and PYR could attenuate TLR4 signaling in the PVN, thereby reducing blood pressure."

IO biomarker • Journal • Preclinical • Anesthesia • Cardiovascular • Gynecology • Hypertension • Inflammation • AVEN • FOS • IL1B • TLR4 • TNFA

New Sulfonate-Semicarbazone Hybrid Molecules: Synthesis, Theoretical Evaluations, Molecular Simulations, and Butyrylcholinesterase Inhibition Activity. (PubMed, ACS Omega) - "Among all compounds, 4-[(E)-(2-carbamoylhydrazinylidene)-methyl]-phenyl 2-(trifluoromethoxy)-benzene-1-sulfonate (12), 4-[(E)-(2-carbamoylhydrazinylidene)-methyl]-phenyl naphthalene-1-sulfonate (17), and 4-[(E)-(2-carbamoylhydrazinylidene)-methyl]-phenyl naphthalene-2-sulfonate (18) exhibited the most potent BChE inhibition, with IC50 values of 61.88, 77.02, and 93.67 μM, respectively, outperforming the reference drug pyridostigmine bromide (IC50: 130.04 μM)...Furthermore, in silico ADME predictions for the most active molecules showed good pharmacokinetic profiles and drug-likeness. Consequently, the results suggested that semicarbazone-sulfonate hybrid compounds 12, 17, and 18 were promising potential multifunctional agents targeting cholinergic dysfunction in Alzheimer's disease (AD)."

Journal • Alzheimer's Disease • CNS Disorders

PESTI: Pyridostigmine Efficacy and Safety for Treatment of Ileus After Colorectal Surgery (clinicaltrials.gov) - P2/3 | N=50 | Recruiting | Sponsor: Stefan Holubar MD MS FACS, FASCRS | Trial completion date: Oct 2025 ➔ Oct 2026 | Trial primary completion date: Sep 2025 ➔ Sep 2026

Trial completion date • Trial primary completion date

Pharmacodynamics, Safety, and Tolerability of Pyridostigmine Bromide in Heart Failure. (PubMed, Curr Ther Res Clin Exp) - P2 | "Further investigations are needed to delineate pharmacodynamic and pathobiological factors contributing to these findings. ClinicalTrials.gov identifier: NCT01415921."

Clinical • Journal • PK/PD data • Cardiovascular • Congestive Heart Failure • Heart Failure

Age- and sex-associated effects of C18 ceramide sphingolipids on osteoclastogenesis in experimental models of Gulf War Illness. (PubMed, Biomed Pharmacother) - "Approximately 60 % of Gulf War Illness (GWI) cases are correlated with toxic exposure to permethrin (PER) and pyridostigmine bromide (PB) in Veterans...In addition, C18:1 diminished RANKL-primed osteoclastogenesis in young male as well as young and aged female mouse osteoclast precursors in the presence of PER in vitro. As Veterans with GWI rapidly approach the senior 65+ age range, further studies are warranted to evaluate the potential link between Gulf War toxic exposure and ceramide sphingolipids in age- and sex-associated osteoclastogenesis."

Journal

Modeling gulf war illness: Anxiety, memory deficits, cholinergic and Potassium Channel imbalance in male and female mice. (PubMed, Life Sci) - "We modeled a GW-like exposure in male and female C57BL/6 J mice using pyridostigmine bromide (PB), permethrin (PER), N, N-diethyl-meta-toluamide (DEET), moderate stress, and Diisopropylfluorophosphate (DFP), a sarin analog...Proteomics analysis supported the presence of sex-dependent neurobiological alterations, with both sexes showing disruptions in proteins involved in neuronal signaling and mitochondrial metabolism, yet involving distinct molecular signatures. These findings underscore the sexually dimorphic nature of GWI pathophysiology."

Journal • Preclinical • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Inflammation • Mood Disorders • Pain • Psychiatry • CHAT • GFAP

Vagal Stimulation in POTS (clinicaltrials.gov) - P1 | N=11 | Active, not recruiting | Sponsor: Vanderbilt University Medical Center | Trial completion date: Dec 2025 ➔ Dec 2026 | Trial primary completion date: Jun 2025 ➔ Jun 2026

Trial completion date • Trial primary completion date • Cardiovascular