[Clinical effect of tacrolimus in the treatment of myasthenia gravis in children].
Zhongguo Dang Dai Er Ke Za Zhi
; 22(9): 964-969, 2020 Sep.
Article
em Zh
| MEDLINE
| ID: mdl-32933627
ABSTRACT
OBJECTIVE:
To evaluate the efficacy and safety of tacrolimus in the treatment of children with myasthenia gravis (MG).METHODS:
A total of 28 children with MG were treated with tacrolimus. MG-Activities of Daily Living (MG-ADL) scale was used to assess clinical outcome and safety after 1, 3, 6, 9, and 12 months of treatment.RESULTS:
After tacrolimus treatment, the MG-ADL score at 1, 3, 6, 9 and 12 months was lower than that at baseline (P<0.05), and the MG-ADL score showed a gradually decreasing trend. The response rates to tacrolimus treatment at 1, 3, 6, 9, and 12 months were 59%, 81%, 84%, 88%, and 88% respectively. At 6, 9, 12, and 18 months of treatment, 4, 13, 14, and 15 children respectively were withdrawn from prednisone. No recurrence was observed during treatment. Major adverse reactions/events were asymptomatic reduction in blood magnesium in 5 children and positive urine occult blood in 1 child, which turned negative without special treatment, and tacrolimus was not stopped due to such adverse reactions/events. One child was withdrawn from tacrolimus due to recurrent vomiting. According to CYP3A5 genotypes, all of the patients were divided into two groups slow metabolic type (n=19) and non-slow metabolic type (fast metabolic type + intermediate type; n=9). The non-slow metabolism group received a higher dose of tacrolimus, but had a lower trough concentration of tacrolimus than the slow metabolism group (P<0.05). The slow metabolism group had a higher response rates to tacrolimus treatment than the non-slow metabolism group (P<0.05).CONCLUSIONS:
Tacrolimus appears to be effective and safe in the treatment of children with MG and is thus an option for immunosuppressive therapy. CYP3A5 genotyping has a certain guiding significance for determining the dosage of tacrolimus.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Tacrolimo
/
Miastenia Gravis
Limite:
Child
/
Humans
Idioma:
Zh
Ano de publicação:
2020
Tipo de documento:
Article