Early aggressive treatment strategy against myasthenia gravis.
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| 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 improvement 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.
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| Authors | Yuriko Nagane, Shigeaki Suzuki, Norihiro Suzuki, Kimiaki Utsugisawa |
| Journal | European neurology (Eur Neurol) Vol. 65 Issue 1 Pg. 16-22 ( 2011) ISSN: 1421-9913 [Electronic] Switzerland |
| PMID | 21116111 (Publication Type: Journal Article) |
| Copyright | Copyright © 2010 S. Karger AG, Basel. |
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