title: Oral corticosteroid therapy and present disease status in myasthenia gravis.
abstract: BACKGROUND
  The aim of this study was to elucidate the effectiveness of oral prednisolone (PSL) according to dosing regimen in 472 patients with myasthenia gravis (MG).
  
  
  METHODS
  We compared the clinical characteristics and PSL treatment between 226 patients who achieved minimal manifestations (MM) or better and 246 patients who remained improved (I) or worsened, according to the MG Foundation of America postintervention status.
  
  
  RESULTS
  Achievement of MM or better at peak PSL dose (odds ratio 12.25, P < 0.0001) and combined use of plasma exchange/plasmapheresis (PE/PP) and/or intravenous immunoglobulin (IVIg) (odds ratio 1.92, P = 0.04) were associated positively, and total PSL dose during the past year (odds ratio 0.17, P = 0.03) was associated negatively with present MM or better status.
  
  
  CONCLUSIONS
  Higher PSL dose and longer PSL treatment do not ensure better outcome. In the absence of a good response, the PSL dose should be decreased by combining with modalities such as PE/PP or IVIg.
authors.affiliation: Department of Occupational Therapy, Sapporo Medical University School of Health Sciences, S1W17, Chuo-ku, Sapporo, 060-8556, Japan.
authors.forename: Tomihiro
authors.initials: T
authors.lastname: Imai
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Suzuki
authors.forename: Emiko
authors.initials: E
authors.lastname: Tsuda
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Nagane
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Murai
authors.forename: Masayuki
authors.initials: M
authors.lastname: Masuda
authors.forename: Shingo
authors.initials: S
authors.lastname: Konno
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Shunya
authors.initials: S
authors.lastname: Nakane
authors.forename: Kazuo
authors.initials: K
authors.lastname: Fujihara
authors.forename: Norihiro
authors.initials: N
authors.lastname: Suzuki
authors.forename: Kimiaki
authors.initials: K
authors.lastname: Utsugisawa
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007564:Japan; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000175:diagnosis / Q000188:drug therapy*; D010951:Plasma Exchange; D011239:Prednisolone / Q000008:administration & dosage* / Q000627:therapeutic use*; D012044:Regression Analysis; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D016756:Immunoglobulins, Intravenous; D011239:Prednisolone
keywords: cross-sectional study; immunomodulation therapy; myasthenia gravis; postintervention status; prednisolone