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. 2024 Feb 10;24(1):61.
doi: 10.1186/s12883-024-03553-y.

Systematic review of the patient burden of generalised myasthenia gravis in Europe, the Middle East, and Africa

J McCallion  1 , A Borsi  1 , W Noel  1 , J Lee  1 , W Karmous  1 , S Sattler  1 , G M Boggia  1 , E J Hardy  2 , C R Mitchell  2 , S A Mitchell  2 , Nils Erik Gilhus  3   4
Affiliations

Systematic review of the patient burden of generalised myasthenia gravis in Europe, the Middle East, and Africa

J McCallion et al. BMC Neurol. .

Abstract

Background: Myasthenia gravis (MG) is a rare autoimmune disease characterised by muscle weakness, and progression from ocular (oMG) to generalised (gMG) symptoms results in a substantial negative impact on quality of life (QoL). This systematic review aimed to provide an overview of the patient burden experienced by people living with gMG.

Methods: Electronic database searches (conducted March 2022), supplemented by interrogation of grey literature, were conducted to identify studies reporting patient burden outcomes in patients with gMG in Europe, the Middle East and Africa. Results were synthesised narratively due to the heterogeneity across trials.

Results: In total, 39 patient burden publications (representing 38 unique studies) were identified as relevant for inclusion in the systematic review, consisting of 37 publications reporting formal patient-reported outcome measures (PROMs), and two publications describing alternative qualitative assessments of patient experience. The studies included a variety of measures including generic and disease-specific PROMs, as well as symptom-specific PROMs focusing on key comorbidities including depression, anxiety, fatigue and sleep disturbance. The findings showed some variation across studies and PROMs; however, in general there was evidence for worse QoL in patients with gMG than in healthy controls or in patients with oMG, and a trend for worsening QoL with increasing MG severity.

Conclusions: This review highlights the importance of considering patient QoL when developing and assessing treatment and management plans for patients with gMG. However, the heterogeneity identified across studies illustrates the need for further representative and well-powered studies in large cohorts administering consistent, validated questionnaires.

Trial registration: The protocol for this systematic review was registered in PROSPERO: CRD42022328444.

Keywords: Generalised myasthenia gravis; Patient burden; Quality of life; Systematic literature review.

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Conflict of interest statement

JM, AB, WN, JL, WK, SS and GMB are employees of Janssen Pharmaceuticals. EH, CRM and SAM are employees of Mtech Access and received payment from Janssen Pharmaceuticals to carry out this review. NEG hhas received financial support from UCB, Argenx, Janssen, Merck, Roche, Alexion, Immunovant, Huma, Dianthus, Denka, and Grifols.

Figures

Fig. 1
Fig. 1
PRISMA diagram. A Including studies tagged on the basis of country and systematic reviews. B To ensure the most relevant data was being considered for inclusion, a post-hoc amendment to the protocol was included to exclude studies during title/abstract screening that did not indicate relevant outcome data
Fig. 2
Fig. 2
Visual summary of the heterogeneity in the PROMs and comparisons evaluated across the included studies. A One study used the revised version of the MG-QoL-15
See this image and copyright information in PMC

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