Single fiber EMG as an outcome measure in myasthenia gravis: results from a double-blind, placebo-controlled trial.
In a placebo-controlled, therapeutic, pilot trial of mycophenolate mofetil (MM) in autoimmune myasthenia gravis (MG), the authors compared pretreatment and posttreatment single fiber electromyography (SFEMG) jitter measurements performed on the same muscle in a total of 11 patients. The mean jitter value decreased (improved) by an average of 15.4 micros in patients receiving MM (n = 6), compared to an increase (worsening) in mean jitter of 4.0 micros in patients receiving placebo (n = 5). This difference was statistically significant (P = 0.030). In most patients, the change in SFEMG measurements correlated with the change in clinical state as measured by quantitative testing of muscle function. The authors conclude that immunomodulation by MM improves neuromuscular junction function in MG and that SFEMG may be a useful marker of early response in future therapeutic trials in autoimmune MG.
Meriggioli
Matthew N
MN
Department of Neurological Sciences, Rush University, Chicago, Illinois 60612, USA. Matthew_N_Meriggioli@rush.edu
Rowin
Julie
J
D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D016022:Case-Control Studies; D004311:Double-Blind Method; D004576:Electromyography / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D018485:Muscle Fibers, Skeletal / Q000502:physiology; D009157:Myasthenia Gravis / Q000188:drug therapy* / Q000503:physiopathology; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D017063:Outcome Assessment, Health Care; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric
D000894:Anti-Inflammatory Agents, Non-Steroidal; D009173:Mycophenolic Acid