Early fast‐acting treatment strategy against generalized myasthenia gravis

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 M...

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Published in:Muscle & nerve 2017-06, Vol.55 (6), p.794-801
Main Authors: Utsugisawa, Kimiaki, Nagane, Yuriko, Akaishi, Tetsuya, Suzuki, Yasushi, Imai, Tomihiro, Tsuda, Emiko, Minami, Naoya, Uzawa, Akiyuki, Kawaguchi, Naoki, Masuda, Masayuki, Konno, Shingo, Suzuki, Hidekazu, Murai, Hiroyuki, Aoki, Masashi
Format: Article
Language:English
Subjects:
Adult
Aged
Anti-Inflammatory Agents - therapeutic use
Clinical Research
Cohort Studies
Female
Humans
Immunotherapy
Immunotherapy - methods
Japan
Kaplan–Meier method
Male
Middle Aged
Myasthenia
Myasthenia gravis
Myasthenia Gravis - drug therapy
Neuromuscular junctions
oral steroids
Patients
Prednisolone
Prednisolone - therapeutic use
Regression analysis
Statistics, Nonparametric
Steroid hormones
Steroids
Time Factors
treatment strategies
treatment target
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Summary: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
ISSN:0148-639X
1097-4598
DOI:10.1002/mus.25397