Format

Send to

Choose Destination
Muscle Nerve. 2017 Jun;55(6):794-801. doi: 10.1002/mus.25397. Epub 2017 Feb 3.

Early fast-acting treatment strategy against generalized myasthenia gravis.

Author information

1
Department of Neurology, Hanamaki General Hospital, 4-28, Kajoh-chou, Hanamaki, 025-0075, Japan.
2
Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan.
3
Department of Neurology, Sendai Medical Center, Sendai, Japan.
4
Department of Neurology, Sapporo Medical University Hospital, Sapporo, Japan.
5
Department of Neurology, Hokkaido Medical Center, Sapporo, Japan.
6
Department of Neurology, Chiba University School of Medicine, Chiba, Japan.
7
Chiba Neurology Clinic, Chiba, Japan.
8
Department of Neurology, Tokyo Medical University, Tokyo, Japan.
9
Department of Neurology, Toho University Oh-hashi Medical Center, Tokyo, Japan.
10
Department of Neurology, Kinki University School of Medicine, Osaka, Japan.
11
Department of Neurological therapeutics, Kyushu University Graduate School of Medicine, Fukuoka, Japan.

Abstract

INTRODUCTION:

In this study we sought to clarify the effects of early fast-acting treatment (EFT) strategies on the time course for achieving the treatment target in generalized myasthenia gravis (MG).

METHODS:

This retrospective study of 923 consecutive MG patients analyzed 688 generalized MG patients who had received immunotherapy during the disease course. The time to first achieve minimal manifestations (MM) or better while receiving prednisolone at ≤5 mg/day for ≥6 months (MM-or-better-5mg) up to 120 months after starting immunotherapy was compared between EFT and non-EFT patients.

RESULTS:

Achievement of MM-or-better-5mg was more frequent and earlier in the EFT group (P = 0.0004, Wilcoxon test; P = 0.0001, log-rank test). Multivariate Cox regression analysis calculated a hazard ratio of 1.98 (P < 0.0001) for utilization of EFT. Dosing regimens of oral steroids in EFT produced no differences in the time course.

CONCLUSIONS:

EFT strategies are advantageous for early achievement of MM-or-better-5mg. Muscle Nerve 55: 794-801, 2017.

KEYWORDS:

Kaplan-Meier method; myasthenia; oral steroids; treatment strategies; treatment target

PMID:
27603432
PMCID:
PMC5484288
DOI:
10.1002/mus.25397
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Wiley Icon for PubMed Central
Loading ...
Support Center