Short-term and long-term prognoses in AChR-Ab positive very-late-onset myasthenia gravis patients
Background: Very-late-onset myasthenia gravis (VLOMG) refers to myasthenia gravis (MG) with onset at age 65 or older. Current research on VLOMG prognosis remains limited, especially regarding factors influencing outcomes. Objectives: To identify the clinical factors that affect the short- and long-t...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2025-01-01
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| Series: | Therapeutic Advances in Neurological Disorders |
| Online Access: | https://doi.org/10.1177/17562864241309793 |
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| author | Nairong Xie Qing Liu Qi Wen Yaye Wang Haoran Liu Yuting Jiang Yan Lu Li Di Min Wang Wenjia Zhu Xinmei Wen Xuxiang Zhang Xin-Ming Shen Yuwei Da |
| author_facet | Nairong Xie Qing Liu Qi Wen Yaye Wang Haoran Liu Yuting Jiang Yan Lu Li Di Min Wang Wenjia Zhu Xinmei Wen Xuxiang Zhang Xin-Ming Shen Yuwei Da |
| author_sort | Nairong Xie |
| collection | DOAJ |
| description | Background: Very-late-onset myasthenia gravis (VLOMG) refers to myasthenia gravis (MG) with onset at age 65 or older. Current research on VLOMG prognosis remains limited, especially regarding factors influencing outcomes. Objectives: To identify the clinical factors that affect the short- and long-term prognosis of MG patients with an onset age ⩾65 years. Design: This was a single-center, retrospective cohort study of AChR-ab positive VLOMG patients, classified into two subgroups based on age of onset: sub-very-late-onset MG (S-VLOMG, onset age ⩾65 and <75 years), and super-late-onset MG (SLOMG, onset age ⩾75 years). Methods: A total of 93 patients were included, including 75 in the S-VLOMG group and 18 in the SLOMG group. Clinical, therapeutic, and prognosis data were reviewed, and the Cox regression model was used to identify factors influencing short- and long-term prognosis. Results: Patient characteristics were well balanced between the groups. Overall, 49.5% of patients achieved minimal symptom expression (MSE) within 6 months and 86% within 24 months. There was no significant difference between the groups in the proportion achieving MSE at 6 months ( p = 0.635) or 24 months ( p = 0.714). The median time to achieve MSE was also comparable between the S-VLOMG and SLOMG groups (199.0 days vs 280.5 days, p = 0.463). Low baseline MG-ADL score and steroid therapy were associated with better short-term prognosis ( p = 0.007 and p = 0.002, respectively). For long-term prognosis, baseline bulbar and limb involvement, time to treatment initiation, and use of immunosuppressants were significant factors ( p = 0.025, p = 0.004, p = 0.025, and p < 0.0001, respectively). There were no significant differences in side effects or drug withdrawal rates between two groups. Conclusion: This study demonstrated that AChR-ab positive VLOMG patients have a favorable prognosis and responded well to medication, with age and comorbidities showing no significant impact. |
| format | Article |
| id | doaj-art-7a90573bbc2942bdae1d7139fc01ba2b |
| institution | Kabale University |
| issn | 1756-2864 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Neurological Disorders |
| spelling | doaj-art-7a90573bbc2942bdae1d7139fc01ba2b2025-01-08T15:03:35ZengSAGE PublishingTherapeutic Advances in Neurological Disorders1756-28642025-01-011810.1177/17562864241309793Short-term and long-term prognoses in AChR-Ab positive very-late-onset myasthenia gravis patientsNairong XieQing LiuQi WenYaye WangHaoran LiuYuting JiangYan LuLi DiMin WangWenjia ZhuXinmei WenXuxiang ZhangXin-Ming ShenYuwei DaBackground: Very-late-onset myasthenia gravis (VLOMG) refers to myasthenia gravis (MG) with onset at age 65 or older. Current research on VLOMG prognosis remains limited, especially regarding factors influencing outcomes. Objectives: To identify the clinical factors that affect the short- and long-term prognosis of MG patients with an onset age ⩾65 years. Design: This was a single-center, retrospective cohort study of AChR-ab positive VLOMG patients, classified into two subgroups based on age of onset: sub-very-late-onset MG (S-VLOMG, onset age ⩾65 and <75 years), and super-late-onset MG (SLOMG, onset age ⩾75 years). Methods: A total of 93 patients were included, including 75 in the S-VLOMG group and 18 in the SLOMG group. Clinical, therapeutic, and prognosis data were reviewed, and the Cox regression model was used to identify factors influencing short- and long-term prognosis. Results: Patient characteristics were well balanced between the groups. Overall, 49.5% of patients achieved minimal symptom expression (MSE) within 6 months and 86% within 24 months. There was no significant difference between the groups in the proportion achieving MSE at 6 months ( p = 0.635) or 24 months ( p = 0.714). The median time to achieve MSE was also comparable between the S-VLOMG and SLOMG groups (199.0 days vs 280.5 days, p = 0.463). Low baseline MG-ADL score and steroid therapy were associated with better short-term prognosis ( p = 0.007 and p = 0.002, respectively). For long-term prognosis, baseline bulbar and limb involvement, time to treatment initiation, and use of immunosuppressants were significant factors ( p = 0.025, p = 0.004, p = 0.025, and p < 0.0001, respectively). There were no significant differences in side effects or drug withdrawal rates between two groups. Conclusion: This study demonstrated that AChR-ab positive VLOMG patients have a favorable prognosis and responded well to medication, with age and comorbidities showing no significant impact.https://doi.org/10.1177/17562864241309793 |
| spellingShingle | Nairong Xie Qing Liu Qi Wen Yaye Wang Haoran Liu Yuting Jiang Yan Lu Li Di Min Wang Wenjia Zhu Xinmei Wen Xuxiang Zhang Xin-Ming Shen Yuwei Da Short-term and long-term prognoses in AChR-Ab positive very-late-onset myasthenia gravis patients Therapeutic Advances in Neurological Disorders |
| title | Short-term and long-term prognoses in AChR-Ab positive very-late-onset myasthenia gravis patients |
| title_full | Short-term and long-term prognoses in AChR-Ab positive very-late-onset myasthenia gravis patients |
| title_fullStr | Short-term and long-term prognoses in AChR-Ab positive very-late-onset myasthenia gravis patients |
| title_full_unstemmed | Short-term and long-term prognoses in AChR-Ab positive very-late-onset myasthenia gravis patients |
| title_short | Short-term and long-term prognoses in AChR-Ab positive very-late-onset myasthenia gravis patients |
| title_sort | short term and long term prognoses in achr ab positive very late onset myasthenia gravis patients |
| url | https://doi.org/10.1177/17562864241309793 |
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