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Early fast-acting treatment strategy against generalized myasthenia gravis
Kimiaki Utsugisawa MD1,*, Yuriko Nagane MD1, Tetsuya Akaishi MD2, Yasushi Suzuki MD3, Tomihiro Imai MD4, Emiko Tsuda MD4, Naoya Minami MD5, Akiyuki Uzawa MD6, Naoki Kawaguchi MD7, Masayuki Masuda MD8, Shingo Konno MD9, Hidekazu Suzuki MD10, Hiroyuki Murai MD11 andMasashi Aoki MD2
Version of Record online: 3 FEB 2017
Muscle Nerve, 2016
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).
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.
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.
EFT strategies are advantageous for early achievement of MM-or-better-5mg.