Thymectomy may not be associated with clinical improvement in MuSK myasthenia gravis.
Muscle Nerve
; 59(4): 404-410, 2019 04.
Article
in En
| MEDLINE
| ID: mdl-30575980
ABSTRACT
INTRODUCTION:
A randomized trial demonstrated benefit from thymectomy in nonthymomatous acetylcholine receptor (AChR)-antibody positive myasthenia gravis (MG). Uncontrolled observational and histologic studies suggest thymectomy may not be efficacious in anti-muscle-specific kinase (MuSK)-MG.METHODS:
The therapeutic impact of thymectomy was evaluated from data collected for a multicenter, retrospective blinded review of rituximab in MuSK-MG.RESULTS:
Baseline characteristics were similar between thymectomy (n = 26) and nonthymectomy (n = 29) groups, including treatment with rituximab (42% vs. 45%). At last visit, 35% of thymectomy subjects reached the primary endpoint, a Myasthenia Gravis Foundation of America (MGFA) post-intervention status (PIS) score of minimal manifestations (MM) or better, compared with 55% of controls (P = 0.17). After controlling for age at onset of MG, rituximab, prednisone, and intravenous immunoglobulin/plasma exchange treatment, thymectomy was not associated with greater likelihood of favorable clinical outcome (odds ratio = 0.43, 95% confidence interval 0.12-1.53, P = 0.19).DISCUSSION:
Thymectomy was not associated with additional clinical improvement in this multicenter cohort of MuSK-MG patients. Muscle Nerve 59404-410, 2019.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Thymectomy
/
Receptors, Cholinergic
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Receptor Protein-Tyrosine Kinases
/
Myasthenia Gravis
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Adult
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Aged
/
Child
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Female
/
Humans
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Male
/
Middle aged
Language:
En
Journal:
Muscle Nerve
Year:
2019
Document type:
Article
Affiliation country:
United States