Oral corticosteroid therapy and present disease status in myasthenia gravis

Tomihiro Imai; Shigeaki Suzuki; Emiko Tsuda; Yuriko Nagane; Hiroyuki Murai; Masayuki Masuda; Shingo Konno; Yasushi Suzuki; Shunya Nakane; Kazuo Fujihara; Norihiro Suzuki; Kimiaki Utsugisawa

doi:10.1002/mus.24438

Oral corticosteroid therapy and present disease status in myasthenia gravis

Tomihiro Imai, Shigeaki Suzuki, Emiko Tsuda, Yuriko Nagane, Hiroyuki Murai, Masayuki Masuda, Shingo Konno, Yasushi Suzuki, Shunya Nakane, Kazuo Fujihara, Norihiro Suzuki, Kimiaki Utsugisawa

Department of Internal Medicine (Neurology)

Research output: Contribution to journal › Article › peer-review

30 Citations (Scopus)

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.

Original language	English
Pages (from-to)	692-696
Number of pages	5
Journal	Muscle and Nerve
Volume	51
Issue number	5
DOIs	https://doi.org/10.1002/mus.24438
Publication status	Published - 2015 May 1

Keywords

Cross-sectional study
Immunomodulation therapy
Myasthenia gravis
Postintervention status
Prednisolone

ASJC Scopus subject areas

Physiology
Clinical Neurology
Cellular and Molecular Neuroscience
Physiology (medical)

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title = "Oral corticosteroid therapy and present disease status in myasthenia gravis",

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.",

keywords = "Cross-sectional study, Immunomodulation therapy, Myasthenia gravis, Postintervention status, Prednisolone",

author = "Tomihiro Imai and Shigeaki Suzuki and Emiko Tsuda and Yuriko Nagane and Hiroyuki Murai and Masayuki Masuda and Shingo Konno and Yasushi Suzuki and Shunya Nakane and Kazuo Fujihara and Norihiro Suzuki and Kimiaki Utsugisawa",

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AU - Imai, Tomihiro

AU - Suzuki, Shigeaki

AU - Tsuda, Emiko

AU - Nagane, Yuriko

AU - Murai, Hiroyuki

AU - Masuda, Masayuki

AU - Konno, Shingo

AU - Suzuki, Yasushi

AU - Nakane, Shunya

AU - Fujihara, Kazuo

AU - Suzuki, Norihiro

AU - Utsugisawa, Kimiaki

PY - 2015/5/1

Y1 - 2015/5/1

N2 - 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.

AB - 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.

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KW - Postintervention status

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Oral corticosteroid therapy and present disease status in myasthenia gravis

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