Development of a thymectomy trial in nonthymomatous myasthenia gravis patients receiving immunosuppressive therapy.
Thymectomy has been regularly used in the management of nonthymomatous autoimmune myasthenia gravis (MG), but its benefits have not been established in a randomized, controlled trial. The widespread use of thymectomy in MG patients without thymoma is largely based on retrospective, nonrandomized case series that have produced a consensus that the procedure is sometimes beneficial. Still, the benefits and utilization of thymectomy are actively debated among MG experts. In this paper, we describe the development of a multicenter, international trial to determine whether extended transsternal thymectomy reduces corticosteroid requirements for patients with generalized AChR antibody-positive nonthymomatous MG.
Department of Neurology, University of Texas Southwestern Medical School, Dallas, Texas 75390-8897, USA. gil.wolfe@utsouthwestern.edu
Gil I
GI
Wolfe
Henry J
HJ
Kaminski
Alfred
A
Jaretzki
Anthony
A
Swan
John
J
Newsom-Davis
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D017668:Age of Onset; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods*; D007166:Immunosuppressive Agents; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000097:blood / Q000150:complications / Q000276:immunology / Q000628:therapy*; D018579:Patient Selection; D011379:Prognosis; D011950:Receptors, Cholinergic / Q000276:immunology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016037:Single-Blind Method; D013934:Thymectomy / Q000379:methods*; D013945:Thymoma / Q000097:blood / Q000150:complications / Q000601:surgery*; D013953:Thymus Neoplasms / Q000097:blood / Q000150:complications / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D011950:Receptors, Cholinergic