A number of mainly retrospective observational studies have indicated a potential benefit of rituximab in generalized MG, in particular among individuals with MuSK+.16,19,21 In most cases this concerned refractory MG, ie, individuals with longer disease duration with previous or ongoing exposure to other immunosuppressive agents, as also reflected by current treatment guidelines.5 However, so far, evidence obtained in a controlled setting has been scarce. The gene discussed is MUSK; the disease is myasthenia gravis.