A commentary on efgartigimod in generalized myasthenia gravis highlighted a clinical gap: post-operative myasthenic crisis is often treated too late or as a diagnosis of exclusion. The authors urged parallel immunotherapy strategies, bedside diaphragmatic ultrasound monitoring, and rescue plans specific to biologic mechanisms. Meanwhile, a 52-week phase 3 study of agalsidase alfa in Fabry disease reported that the therapy was generally well tolerated and maintained stable kidney and cardiac measures while producing sustained reductions in lyso-Gb3 in treatment-naïve patients. These updates show two different ends of the therapeutic spectrum—perioperative optimization for immunology-driven neuromuscular disease and long-horizon biochemical control for lysosomal storage disorders—while sharing an emphasis on measurement-driven management. For clinicians and product teams, the message is to tighten timing and monitoring loops, not just to add more dosing options.