Treatment of myasthenia gravis patients with calcineurin inhibitors in Japan: A retrospective analysis of outcomes

Kimiaki Utsugisawa, Yuriko Nagane, Tomihiro Imai, Masakatsu Motomura, Masayuki Masuda, Shingo Konno, Shigeaki Suzuki

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objectives Calcineurin inhibitors (CNI) are approved for the treatment of myasthenia gravis (MG) in Japan. However, the extent to which CNI have been effective remains unclear. Here we report data regarding CNI use and outcomes of MG. Methods We evaluated 640 consecutive MG patients by a multicenter survey. Patients not receiving any immune treatment were excluded, and cross-sectional and retrospective data of 515 patients receiving immune treatment with (n = 312) or without (n = 203) CNI were analyzed. Results Compared with patients treated without CNI, those treated with CNI had a higher frequency of MG Foundation of America Class III-V and higher severity disease at the worst clinical condition, and also had current higher severity, worse quality of life and higher daily doses of prednisolone, despite taking equivalent prednisolone dosages during the course of treatment. Achieving a treatment target was less frequent in the group treated with CNI. Onset age was not different between the two groups. Duration before CNI use after starting corticosteroids was 4.4 ± 6.3 years. Among those treated with CNI, late-onset MG patients achieved a more favorable current condition than did those with early-onset and thymoma-associated MG, whereas there was no such difference without CNI treatment. Conclusions CNI were given to severely ill MG patients with no attempt to select those more likely to respond, and failed to exert a strong impact on MG therapy. CNI should be given aggressively to patients with factors known to enhance susceptibility to these drugs, such as higher age at onset and early-stage disease.

Original languageEnglish
Pages (from-to)195-200
Number of pages6
JournalClinical and Experimental Neuroimmunology
Volume6
Issue number2
DOIs
Publication statusPublished - 2015 May 1

Fingerprint

Myasthenia Gravis
Japan
Therapeutics
Prednisolone
Age of Onset
Calcineurin Inhibitors
Thymoma
Adrenal Cortex Hormones
Quality of Life

Keywords

  • calcineurin inhibitors
  • cyclosporine
  • myasthenia
  • quality of life
  • tacrolimus

ASJC Scopus subject areas

  • Clinical Neurology
  • Immunology and Microbiology (miscellaneous)
  • Neuroscience (miscellaneous)
  • Immunology

Cite this

Treatment of myasthenia gravis patients with calcineurin inhibitors in Japan : A retrospective analysis of outcomes. / Utsugisawa, Kimiaki; Nagane, Yuriko; Imai, Tomihiro; Motomura, Masakatsu; Masuda, Masayuki; Konno, Shingo; Suzuki, Shigeaki.

In: Clinical and Experimental Neuroimmunology, Vol. 6, No. 2, 01.05.2015, p. 195-200.

Research output: Contribution to journalArticle

Utsugisawa, Kimiaki ; Nagane, Yuriko ; Imai, Tomihiro ; Motomura, Masakatsu ; Masuda, Masayuki ; Konno, Shingo ; Suzuki, Shigeaki. / Treatment of myasthenia gravis patients with calcineurin inhibitors in Japan : A retrospective analysis of outcomes. In: Clinical and Experimental Neuroimmunology. 2015 ; Vol. 6, No. 2. pp. 195-200.
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