Early aggressive treatment strategy against myasthenia gravis

Yuriko Nagane, Shigeaki Suzuki, Norihiro Suzuki, Kimiaki Utsugisawa

Research output: Contribution to journalArticle

32 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 1

Keywords

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

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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