title: Factors associated with response to calcineurin inhibitors in myasthenia gravis.
abstract: The objective was to assess which clinical factors of patients with myasthenia gravis (MG) are associated with responsiveness to calcineurin inhibitors (CNIs, cyclosporine and tacrolimus). We retrospectively analyzed the 6-month effects of CNIs in 62 MG patients. We excluded the influence of other immune treatments and determined factors associated with response to CNIs. The frequency of patients who achieved neither a > or =3-point reduction in quantitative MG score nor a > or =25% reduction in daily dose of prednisolone (poor responders) reached 35.5% (22/62) and 64.5% (40/62), respectively, compared with patients who achieved at least one of these improvements (responders). Neither dose nor blood concentration of CNIs differed between groups. Multivariate logistic regression analysis revealed time since onset of disease [odds ratio (OR) = 0.85, P = 0.005] and presence of thymoma (OR = 5.56, P = 0.05) as clinical factors that predict response to CNIs. As for MG-related autoantibody status, an autoantibody against a voltage-gated potassium channel, Kv1.4, was associated with response (OR = 9.01, P = 0.04) and showed a correlation with the presence of thymoma (P < 0.01). In MG, the early stages of disease and thymoma-associated MG are responsive to treatment with CNIs.
authors.affiliation: Department of Neurology, Hanamaki General Hospital, 4-28 Kajoh-chou, Hanamaki 025-0075, Japan.
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Nagane
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Suzuki
authors.forename: Norihiro
authors.initials: N
authors.lastname: Suzuki
authors.forename: Kimiaki
authors.initials: K
authors.lastname: Utsugisawa
mesh_terms: D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood; D065095:Calcineurin Inhibitors; D016572:Cyclosporine / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007167:Immunotherapy; D051665:Kv1.4 Potassium Channel / Q000276:immunology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016559:Tacrolimus / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D013945:Thymoma / Q000150:complications; D016896:Treatment Outcome
chemical_list: D001323:Autoantibodies; D065095:Calcineurin Inhibitors; D051665:Kv1.4 Potassium Channel; D016572:Cyclosporine; D016559:Tacrolimus