Early aggressive treatment strategy against myasthenia gravis

Yuriko Nagane, Shigeaki Suzuki, Norihiro Suzuki, Kimiaki Utsugisawa

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background/Aims: In treating myasthenia gravis (MG), our aims were to achieve early minimal manifestations (MM) by performing early aggressive therapy (EAT) using plasmapheresis and high-dose intravenous methylprednisolone, and then to maintain the status with low-dose oral corticosteroids (EAT strategy). We examined the merits of the EAT strategy. Methods: We retrospectively analyzed long-term effects of the EAT strategy (duration of therapy: 4.1 years) for 49 de novo MG patients and compared the effects to those of high-dose oral prednisolone therapy for 22 patients. Results: The EAT group achieved marked early improve- ment with much lower doses of oral prednisolone compared to the high-dose prednisolone group. The patients who achieved MM with prednisolone ≤5 mg/day were more frequent in the EAT group at both 1 year (57.1 vs. 4.5%) and final observation (77.6 vs. 27.3%). Both new-onset diabetes and patients who had complained of moon face were less frequent in the EAT group. However, in the EAT group, due to a temporary inability to maintain MM, additional short-term hospitalizations to return to MM by EAT were required. Conclusions: The EAT strategy has advantages of early improvement with less frequent steroid-related complications. The labor and cost required are evident disadvantages.

Original languageEnglish
Pages (from-to)16-22
Number of pages7
JournalEuropean Neurology
Volume65
Issue number1
DOIs
Publication statusPublished - 2011 Jan

Fingerprint

Myasthenia Gravis
Secondary Prevention
Prednisolone
Therapeutics
Plasmapheresis
Methylprednisolone
Adrenal Cortex Hormones
Hospitalization
Steroids
Observation
Costs and Cost Analysis

Keywords

  • Aggressive therapy
  • Corticosteroids
  • High-dose intravenous methylprednisolone
  • Myasthenia gravis
  • Plasmapheresis
  • Prednisolone

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Early aggressive treatment strategy against myasthenia gravis. / Nagane, Yuriko; Suzuki, Shigeaki; Suzuki, Norihiro; Utsugisawa, Kimiaki.

In: European Neurology, Vol. 65, No. 1, 01.2011, p. 16-22.

Research output: Contribution to journalArticle

Nagane, Yuriko ; Suzuki, Shigeaki ; Suzuki, Norihiro ; Utsugisawa, Kimiaki. / Early aggressive treatment strategy against myasthenia gravis. In: European Neurology. 2011 ; Vol. 65, No. 1. pp. 16-22.
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