The effect of prednisone on the progression from ocular to generalized myasthenia gravis.
Fifty percent of ocular myasthenia gravis (OMG) patients will progress to generalized myasthenia, 90% within 3 years from the onset of ocular symptoms. This study was performed to determine whether treatment with oral prednisone initiated and completed within 2 years from the onset of ocular symptoms would affect the progression of ocular myasthenia to generalized myasthenia gravis (GMG). Fifty-six patients were included in this review, with 27 patients in the prednisone-treated group and 29 patients in the untreated group. The treated group was initiated on 60 mg of prednisone daily with a slow taper over 3-6 months. At 2 years, significantly fewer patients in the treated group (3 of 27) progressed to generalized myasthenia when compared to the untreated group (10 of 29) (chi(2), p=0.04). Our results suggest that the early use of steroids may decrease progression of ocular to generalized myasthenia gravis. The decision to use steroids should be considered early in the course of patients diagnosed with ocular myasthenia gravis. This study should be considered preliminary and a prospective trial is warranted to confirm our observations.
Monsul
Nicholas T
NT
Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, CT, USA.
Patwa
Huned S
HS
Knorr
Amy M
AM
Lesser
Robert L
RL
Goldstein
Jonathan M
JM
D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000188:drug therapy* / Q000503:physiopathology / Q000517:prevention & control*; D009801:Oculomotor Muscles / Q000187:drug effects / Q000276:immunology / Q000503:physiopathology; D011241:Prednisone / Q000627:therapeutic use*; D011729:Pyridostigmine Bromide / Q000627:therapeutic use; D011950:Receptors, Cholinergic / Q000187:drug effects / Q000276:immunology; D012189:Retrospective Studies; D016896:Treatment Outcome
D002800:Cholinesterase Inhibitors; D007166:Immunosuppressive Agents; D011950:Receptors, Cholinergic; D011729:Pyridostigmine Bromide; D011241:Prednisone