[Pubmed] Effectiveness of early cycles of fast-acting treatment in generalised myasthenia gravis
Posté : 24 janv. 2023 12:00
J Neurol Neurosurg Psychiatry. 2023 Jan 24:jnnp-2022-330519. doi: 10.1136/jnnp-2022-330519. Online ahead of print.
ABSTRACT
BACKGROUND: Early fast-acting treatment (EFT) is the aggressive use of fast-acting therapies such as plasmapheresis, intravenous immunoglobulin and/or intravenous high-dose methylprednisolone (IVMP) from the early phases of treatment. EFT is reportedly beneficial for early achievement of minimal manifestations (MM) or better status with ≤5 mg/day prednisolone (MM5mg), a practical therapeutic target for myasthenia gravis (MG).
OBJECTIVE: The current study aimed to clarify which specific EFT regimen is efficacious and the patient characteristics that confer sensitivity to EFT.
METHODS: We recruited a total of 1710 consecutive patients with MG who enrolled in the Japan MG Registry for this large-cohort study. Among them, 1066 with generalised MG who had received immunotherapy were analysed. Prognostic background factors were matched in a 1:1 ratio using propensity score matching analysis between patients treated with EFT (n=350) and those treated without EFT (n=350). The clinical course and time to first achieve MM5mg after starting immunotherapy was analysed in relation to treatment combinations and patient characteristics.
RESULTS: Kaplan-Meier analyses showed that EFT had a significant effect on the achievement of MM5mg (p
Source: https://pubmed.ncbi.nlm.nih.gov/3669372 ... t6+86293ac