title: Health-related quality-of-life and treatment targets in myasthenia gravis.
abstract: BACKGROUND
  The aim of this study was to determine factors affecting health-related quality of life (HRQOL) and to propose appropriate treatment targets for patients with myasthenia gravis (MG).
  
  
  METHODS
  We evaluated 640 consecutive patients with MG seen at 11 neurological centers. Two-year follow-up data were obtained for 282 patients. Correlations between detailed clinical factors and the Japanese version of the 15-item MG-specific QOL scale score were analyzed.
  
  
  RESULTS
  In a cross-sectional analysis of 640 MG patients, multivariate regression revealed that disease severity, as evaluated by the MG Composite (P<0.0001), total dose of oral prednisolone during the last year (P=0.002), and Cushingoid appearance index (P=0.0004), showed significant negative effects on HRQOL, but the quantitative MG score and current prednisolone dose did not.
  
  
  CONCLUSIONS
  Achieving minimal manifestations (MM) status or better with prednisolone ≤ 5 mg/day was found to exert a major positive impact on HRQOL in both the cross-sectional and 2-year follow-up patient samples and can be recommended as a treatment target.
authors.affiliation: Department of Neurology, Hanamaki General Hospital, 4-28 Kajoh-chou, Hanamaki, 025-0075, Japan.
authors.forename: Kimiaki
authors.initials: K
authors.lastname: Utsugisawa
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Suzuki
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Nagane
authors.forename: Masayuki
authors.initials: M
authors.lastname: Masuda
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Murai
authors.forename: Tomihiro
authors.initials: T
authors.lastname: Imai
authors.forename: Emiko
authors.initials: E
authors.lastname: Tsuda
authors.forename: Shingo
authors.initials: S
authors.lastname: Konno
authors.forename: Shunya
authors.initials: S
authors.lastname: Nakane
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Kazuo
authors.initials: K
authors.lastname: Fujihara
authors.forename: Norihiro
authors.initials: N
authors.lastname: Suzuki
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D007564:Japan; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000503:physiopathology* / Q000523:psychology* / Q000628:therapy; D011788:Quality of Life / Q000523:psychology*; D012649:Self Concept; D012720:Severity of Illness Index; D013223:Statistics as Topic
keywords: autoimmune diseases; cohort studies; myasthenia; quality of life; treatment