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. 2021 Oct;268(10):3781-3788.
doi: 10.1007/s00415-021-10520-x. Epub 2021 Mar 27.

Long-term outcomes and prognostic factors in generalized myasthenia gravis

Yukiko Ozawa  1 , Akiyuki Uzawa  2 , Manato Yasuda  1 , Yuta Kojima  1   3 , Yosuke Onishi  1 , Fumiko Oda  1   4 , Tetsuya Kanai  1   5 , Keiichi Himuro  1   6 , Naoki Kawaguchi  1   7 , Satoshi Kuwabara  1
Affiliations

Long-term outcomes and prognostic factors in generalized myasthenia gravis

Yukiko Ozawa et al. J Neurol. 2021 Oct.

Abstract

Objective: This study aimed to investigate the timing of meeting the criteria for a status of "minimal manifestation (MM) or better" and the factors that influenced whether "MM or better status" or "MM or better status with an oral prednisolone (PSL) dose of 5 mg/day or less (5-mg MM)" was met in patients with acetylcholine receptor (AChR) antibody-positive generalized myasthenia gravis (MG).

Methods: We performed a retrospective study in 93 patients with AChR antibody-positive generalized MG who were followed for 3 years after the start of immunotherapy. We reviewed clinical data, such as MG-related symptoms, the MG activities of daily living profile (MGADL) score, immunotherapy including the dose of PSL, and achievement of the status of MM or better at baseline and 3, 6, 12, 24, and 36 months after treatment.

Results: An MM or better status was achieved in 60% of the patients 3 months and in 90% of the patients 2 years after initiating immunotherapy. At 2 years, 60% of the patients had achieved the treatment goal, which was an "5-mg MM". More frequent plasmapheresis and higher dose of PSL within 3 months after immunotherapy initiation were associated with difficulty in achieving the 5-mg MM status at 2 years.

Conclusion: Approximately 60% of the MG patients achieved the treatment goal within 2 years after treatment. PSL dose and the cumulative number of plasmapheresis procedures at 3 months after immunotherapy initiation may help identify treatment-resistant patients with MG.

Keywords: Anti-AChR antibody; Myasthenia gravis; Prednisolone; Therapeutic goal.

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References

    1. Gilhus NE, Verschuuren JJ (2015) Myasthenia gravis: subgroup classification and therapeutic strategies. Lancet Neurol 14(10):1023–1036. https://doi.org/10.1016/s1474-4422(15)00145-3 - DOI - PubMed
    1. Meriggioli MN, Sanders DB (2009) Autoimmune myasthenia gravis: emerging clinical and biological heterogeneity. Lancet Neurol 8(5):475–490. https://doi.org/10.1016/s1474-4422(09)70063-8 - DOI - PubMed - PMC
    1. Sanders DB, Wolfe GI, Benatar M, Evoli A, Gilhus NE, Illa I, Kuntz N, Massey JM, Melms A, Murai H, Nicolle M, Palace J, Richman DP, Verschuuren J, Narayanaswami P (2016) International consensus guidance for management of myasthenia gravis: executive summary. Neurology 87(4):419–425. https://doi.org/10.1212/wnl.0000000000002790 - DOI - PubMed - PMC
    1. Grob D, Brunner N, Namba T, Pagala M (2008) Lifetime course of myasthenia gravis. Muscle Nerve 37(2):141–149. https://doi.org/10.1002/mus.20950 - DOI - PubMed
    1. Sanders DB, Evoli A (2010) Immunosuppressive therapies in myasthenia gravis. Autoimmunity 43(5–6):428–435. https://doi.org/10.3109/08916930903518107 - DOI - PubMed

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