Benefits of FK506 (tacrolimus) for residual, cyclosporin- and prednisone-resistant myasthenia gravis: one-year follow-up of an open-label study.
Thirteen patients with myasthenia gravis, unresponsive to prednisone and cyclosporin after thymectomy, received KF506 (tacrolimus) for 12 months, at starting doses of 0.1 mg/kg per day b.i.d. and then adjusted to achieve plasma concentrations between 7 and 8 ng/mL. The doses of prednisone were progressively reduced and finally discontinued. Anti-acetylcholine antibodies and myasthenia gravis score for disease severity decreased significantly and muscular strength increased by 37%. All patients achieved pharmacological remission, 11 were asymptomatic and two had minimal weakness of eyelid closure. Tacrolimus was well tolerated and appears a suitable approach after unsuccessful treatment with conventional immunosuppressants in patients with disabling myasthenia.
Ponseti
José M
JM
Unit of Myasthenia Gravis, Department of Surgery, Hospital General Universitari Vall d'Hebron, Autonomous University of Barcelona, Passeig Vall d'Hebron 119-129, E-08035 Barcelona, Spain. ponseti@hg.vhebron.es
Azem
Jamal
J
Fort
José M
JM
Codina
Agustín
A
Montoro
J Bruno
JB
Armengol
Manuel
M
D000328:Adult; D000368:Aged; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000097:blood; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000097:blood / Q000188:drug therapy*; D011239:Prednisolone / Q000008:administration & dosage; D011446:Prospective Studies; D016559:Tacrolimus / Q000008:administration & dosage* / Q000097:blood; D016896:Treatment Outcome
D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D011239:Prednisolone; D016559:Tacrolimus