Safety of prednisone for ocular myasthenia gravis.

Abstract

BACKGROUND:

Treatment with chronic corticosteroids has been associated with frequent significant adverse effects. We hypothesized that a long-term low-dose prednisone regimen for ocular myasthenia gravis (OMG) would have a low rate of major side effects.

METHODS:

Consecutive OMG patients from a single institution over a 16-year period and treated with ≥1 month of daily prednisone were included. Steroid-related complications were defined as the development/worsening of conditions requiring alteration to medical therapy. Serious complications included conditions requiring emergency care, hospitalization, or surgery.

RESULTS:

Eighty-three patients with follow-up period ranging from 1 to 271 months (median, 58 months) were included. Fifty-eight (70%) patients had follow-up period of ≥24 months. The maximum prednisone dose ranged from 10 to 60 mg. Tapering to ≤10 mg/d required ≤4 months for all but 2 patients. Median average daily dose following the initial course was 5 mg daily (interquartile range, 4-7.5 mg). During the first 2 years, there were 24.5 complications per 100 person-years. Only one patient had a serious complication within the first 2 years (2-year cumulative risk, 1%), but this individual was not following the recommended regimen.

CONCLUSIONS:

Low-dose prednisone for OMG has an acceptable side-effect profile and causes few serious complications (2-year risk, ∼1%). However, patients need monitoring to detect the relatively common, but less serious, complications (2-year risk, ∼39%) to adjust medical therapy in a timely fashion.

• Authors: Beau B Bruce, Mark J Kupersmith
• Journal: Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society (J Neuroophthalmol) Vol. 32 Issue 3 Pg. 212-5 (Sep 2012) ISSN: 1536-5166 [Electronic] United States
• PMID: 22549563 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Inflammatory Agents
• Prednisone

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Anti-Inflammatory Agents (therapeutic use)
• Female
• Humans
• Longitudinal Studies
• Male
• Middle Aged
• Myasthenia Gravis (drug therapy)
• Prednisone (therapeutic use)
• Retrospective Studies
• Treatment Outcome
• Young Adult