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Jul 20, 2016Article Details
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Main Article Content
High-dose immunosuppressive therapy in generalised myasthenia gravis - a 2-year follow-up study
Abstract
Background. Immunosuppressive (IS) therapy is increasingly advocated in the treatment of myasthenia gra vis (MG). This study assessed whether early 'high-dose' IS therapy in new patients with generalised MG (GMG) altered the outcome and reduced the morbidity of GMG.
Methods. Patients with GMG were treated with 'high-dose' IS therapy (prednisone S 1 mg/ kg, azathioprine 2- 3 mg/ kg) and followed up for 2 years. Prednisone and azathioprine were ini tiated on diagnosis. Outcome measures were compared with those of controls previously treated at our clinic with ' low-dose' IS therapy. The primary outcome measure was the number of patients in remission at 1 and 2 years. Secondary outcomes included the MG scores (MGS) after 1 and 2 years, as well as the number of plasma exchanges (P / E), hosp ital and intensive care unit (ICU) admi sions required for decompensated MG.
Findings. At 1 and 2 years there were ignificant improvements in the MGS of patients treated with 'highdose' IS therapy compared wi th those of controls; 50% of these patients were in remission after 2 year compared with less than 16% of controls. The number of hospital and ICU admissions had also dropped significantly in the first year of patients receiving 'high-dose' IS treatment.
Conclusion. Early 'high-dose' IS therapy using azathioprine and prednisone in GMG resul ted in a significant increase in the number of patients in remis ion and reduced morbidity at 1 and 2 years.
