Low-dose tacrolimus treatment in thymectomised and steroid-dependent myasthenia gravis.
OBJECTIVE
The effects of tacrolimus, a new immunosuppressive drug, which inhibits calcineurin pathway and also might enhance corticosteroid (CS) receptor-mediated gene expressions, on clinical outcome and biochemical data were evaluated in thymectomised and steroid-dependent myasthenia gravis (MG) patients.


METHODS
We administrated low-dose tacrolimus (3 mg/day orally) to 17 steroid-dependent thymectomised MG patients. They were followed for 4 to 58 months, average 19.2 months. The MG activities of daily living (MGADL) scores and the dosage of prednisolone (PSL) were assessed at baseline and 4 months later.


RESULTS
The average MGADL scores improved from 6.8 to 5.0 (p < 0.01) at 4 months; to 3.5 at the last visit (p < 0.01) as well as the average dosage of PSL reducing from 31.6 to 24.1 mg/alternate day (p < 0.01) at 4 months; 14.6 mg at the last visit (p < 0.01).


CONCLUSIONS
The additional low dose tacrolimus therapy for steroid-dependent thymectomised MG is effective in improving symptoms as well as allowing the tapering of CSs.
Department of Neurology, Chiba University Graduate School of Medicine, Chiba, Japan. kawaguchi@faculty.chiba-u.jp
Naoki
N
Kawaguchi
Yasumasa
Y
Yoshiyama
Yuko
Y
Nemoto
Shin
S
Munakata
Toshio
T
Fukutake
Takamichi
T
Hattori
D000203:Activities of Daily Living; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery; D016559:Tacrolimus / Q000627:therapeutic use*; D013934:Thymectomy
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D016559:Tacrolimus