According to an editorial, the hope of complete remission was perhaps not realistic judging by previous experience and the observation in this trial that thymectomy patients still required an average of 44mg of prednisone on alternate days. It adds that these data will be useful in counselling patients, but offer no further clarity regarding the selection of patients for thymectomy because subgroup analyses did not allow conclusions regarding the effects of surgery in men versus women or in younger versus older patients. In terms of medical management, it notes that azathioprine has been favoured as an immunosuppressive agent to reduce glucocorticoid doses, but many neuromuscular specialists prefer mycophenolate mofetil, even though benefits have not been shown in clinical trials. It highlights that in the future, alternative drugs, such as rituximab, and new techniques, such as haematopoietic stem-cell transplantation, for resistant cases will play a role, and trials will need to determine whether medical treatment surpasses thymectomy in the overall management of the disease. However, it considers that the appeal of a virtual cure by means of thymectomy is likely to persist because of the unappealing alternative of a long-term commitment to the use of glucocorticoids and immunosuppression.