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The discontinuation was driven by (Bergam, 2025) (Figure 2): the availability of newer, safer & more accurate alternative testing for MG including electrophysiological & antibody tests, as well as safety concerns (bradycardia & respiratory complications) limited diagnostic reliability (with both false-positive and false-negative results) The decision to remove edrophonium as an available (alternative) diagnostic test has been challenged (Keritam et al, 2026)

Retrieved February 3, 2026

doi: 10.1016/j.lfs.2022.120794 19 BarberM

The protein crystal structure of MSA-DH in combination with biochemical studies revealed a covalent catalytic mechanism leading to the enantiomer-specific formation of D-malate