Outcome Predictors of Generalized Myasthenia Gravis: A Prospective Observational Study
Background and Objectives: There is paucity of studies on long-term remission of autoimmune generalized myasthenia gravis (MG) from Southeast Asia. We report the outcome predictors of generalized MG and also evaluate the influence of high- versus low-dose prednisolone and prednisolone with or withou...
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| Language: | English |
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Wolters Kluwer Medknow Publications
2025-01-01
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| Series: | Annals of Indian Academy of Neurology |
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| Online Access: | https://journals.lww.com/10.4103/aian.aian_386_24 |
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| author | Jayantee Kalita Nagendra B Gutti Faim Ahamed |
| author_facet | Jayantee Kalita Nagendra B Gutti Faim Ahamed |
| author_sort | Jayantee Kalita |
| collection | DOAJ |
| description | Background and Objectives:
There is paucity of studies on long-term remission of autoimmune generalized myasthenia gravis (MG) from Southeast Asia. We report the outcome predictors of generalized MG and also evaluate the influence of high- versus low-dose prednisolone and prednisolone with or without azathioprine (AZA).
Methods:
Fifty-seven patients with generalized MG were included, who completed 2 years of follow-up. Demographic information, comorbidities, Myasthenia Gravis Foundation of America (MGFA) class at baseline and follow-up, acetylcholine receptor (AChR) and muscle-specific kinase antibodies, decremental response, thymectomy, and treatments were recorded. Maximum doses of prednisolone, AZA, and acetylcholinesterase inhibitors were noted. The predictors of MGFA 0 at 3 and 6 months and minimal manifestation (MM) status at 2 years were evaluated.
Results:
MGFA 0 was achieved by 27 (47.4%) patients at 3 months, 35 (61.4%) patients at 6 months, and 46 (80.7%) patients at 12 months. At 2 years, 48 (84.2%) patients achieved the MM status and none achieved complete stable or pharmacologic remission. On multivariate analysis, AChR antibody titer (adjusted odds ratio [AOR] 1.08, 95% confidence interval [CI] 1.006–1.167; P = 0.03) and MG activity of daily living (MGADL) at 6 months (AOR 1.28, 95% CI 1.066–1.558; P = 0.01) predicted the MM status. Maximum dose of prednisolone and adjunctive AZA did not predict the MM status.
Conclusions:
About 84.2% of patients with generalized MG, especially those with a low AChR antibody titer and MGADL < 4 at 6 months, achieved the MM status at 2 years. |
| format | Article |
| id | doaj-art-7b14ecd987b34d0fa0d2abf48cb4fa8c |
| institution | DOAJ |
| issn | 0972-2327 1998-3549 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Indian Academy of Neurology |
| spelling | doaj-art-7b14ecd987b34d0fa0d2abf48cb4fa8c2025-08-20T03:16:35ZengWolters Kluwer Medknow PublicationsAnnals of Indian Academy of Neurology0972-23271998-35492025-01-01281586510.4103/aian.aian_386_24Outcome Predictors of Generalized Myasthenia Gravis: A Prospective Observational StudyJayantee KalitaNagendra B GuttiFaim AhamedBackground and Objectives: There is paucity of studies on long-term remission of autoimmune generalized myasthenia gravis (MG) from Southeast Asia. We report the outcome predictors of generalized MG and also evaluate the influence of high- versus low-dose prednisolone and prednisolone with or without azathioprine (AZA). Methods: Fifty-seven patients with generalized MG were included, who completed 2 years of follow-up. Demographic information, comorbidities, Myasthenia Gravis Foundation of America (MGFA) class at baseline and follow-up, acetylcholine receptor (AChR) and muscle-specific kinase antibodies, decremental response, thymectomy, and treatments were recorded. Maximum doses of prednisolone, AZA, and acetylcholinesterase inhibitors were noted. The predictors of MGFA 0 at 3 and 6 months and minimal manifestation (MM) status at 2 years were evaluated. Results: MGFA 0 was achieved by 27 (47.4%) patients at 3 months, 35 (61.4%) patients at 6 months, and 46 (80.7%) patients at 12 months. At 2 years, 48 (84.2%) patients achieved the MM status and none achieved complete stable or pharmacologic remission. On multivariate analysis, AChR antibody titer (adjusted odds ratio [AOR] 1.08, 95% confidence interval [CI] 1.006–1.167; P = 0.03) and MG activity of daily living (MGADL) at 6 months (AOR 1.28, 95% CI 1.066–1.558; P = 0.01) predicted the MM status. Maximum dose of prednisolone and adjunctive AZA did not predict the MM status. Conclusions: About 84.2% of patients with generalized MG, especially those with a low AChR antibody titer and MGADL < 4 at 6 months, achieved the MM status at 2 years.https://journals.lww.com/10.4103/aian.aian_386_24acetyl choline receptor antibodyazathioprinemyasthenia crisismyasthenia gravisoutcomeprednisoloneprognosis |
| spellingShingle | Jayantee Kalita Nagendra B Gutti Faim Ahamed Outcome Predictors of Generalized Myasthenia Gravis: A Prospective Observational Study Annals of Indian Academy of Neurology acetyl choline receptor antibody azathioprine myasthenia crisis myasthenia gravis outcome prednisolone prognosis |
| title | Outcome Predictors of Generalized Myasthenia Gravis: A Prospective Observational Study |
| title_full | Outcome Predictors of Generalized Myasthenia Gravis: A Prospective Observational Study |
| title_fullStr | Outcome Predictors of Generalized Myasthenia Gravis: A Prospective Observational Study |
| title_full_unstemmed | Outcome Predictors of Generalized Myasthenia Gravis: A Prospective Observational Study |
| title_short | Outcome Predictors of Generalized Myasthenia Gravis: A Prospective Observational Study |
| title_sort | outcome predictors of generalized myasthenia gravis a prospective observational study |
| topic | acetyl choline receptor antibody azathioprine myasthenia crisis myasthenia gravis outcome prednisolone prognosis |
| url | https://journals.lww.com/10.4103/aian.aian_386_24 |
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