Oral corticosteroid therapy and present disease status in myasthenia gravis |
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| Authors: | Tomihiro Imai MD Shigeaki Suzuki MD Emiko Tsuda MD Yuriko Nagane MD Hiroyuki Murai MD Masayuki Masuda MD Shingo Konno MD Yasushi Suzuki MD Shunya Nakane MD Kazuo Fujihara MD Norihiro Suzuki MD Kimiaki Utsugisawa MD |
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| Affiliation: | 1. Department of Occupational Therapy, Sapporo Medical University School of Health Sciences, Chuo‐ku, Sapporo, Japan;2. Department of Neurology, Keio University School of Medicine, Tokyo, Japan;3. Department of Neurology, Sapporo Medical University School of Medicine, Sapporo, Japan;4. Department of Neurology, Hanamaki General Hospital, Hanamaki, Japan;5. Department of Neurology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan;6. Department of Neurology, Tokyo Medical University, Tokyo, Japan;7. Department of Neurology, Toho University Medical Center Oh‐hashi Hospital, Tokyo, Japan;8. Department of Neurology, National Hospital Organization, Sendai Medical Center, Sendai, Japan;9. Department of Neurology, Nagasaki Kawatana Medical Center, Kawatana, Japan;10. Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan |
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| Abstract: | Introduction: The aim of this study was to elucidate the effectiveness of oral prednisolone (PSL) according to dosing regimen in 472 patients with myasthenia gravis (MG). Methods: We compared the clinical characteristics and PSL treatment between 226 patients who achieved minimal manifestations (MM) or better and 246 patients who remained improved (I) or worsened, according to the MG Foundation of America postintervention status. Results: Achievement of MM or better at peak PSL dose (odds ratio 12.25, P < 0.0001) and combined use of plasma exchange/plasmapheresis (PE/PP) and/or intravenous immunoglobulin (IVIg) (odds ratio 1.92, P = 0.04) were associated positively, and total PSL dose during the past year (odds ratio 0.17, P = 0.03) was associated negatively with present MM or better status. Conclusions: Higher PSL dose and longer PSL treatment do not ensure better outcome. In the absence of a good response, the PSL dose should be decreased by combining with modalities such as PE/PP or IVIg. Muscle Nerve 51 :692–696, 2015 |
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| Keywords: | cross‐sectional study immunomodulation therapy myasthenia gravis postintervention status prednisolone |
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