Early fast-acting treatment strategy against generalized myasthenia gravis.
In this study we sought to clarify the effects of early fast-acting treatment (EFT) strategies on the time course for achieving the treatment target in generalized myasthenia gravis (MG).



This retrospective study of 923 consecutive MG patients analyzed 688 generalized MG patients who had received immunotherapy during the disease course. The time to first achieve minimal manifestations (MM) or better while receiving prednisolone at ≤5 mg/day for ≥6 months (MM-or-better-5mg) up to 120 months after starting immunotherapy was compared between EFT and non-EFT patients.



Achievement of MM-or-better-5mg was more frequent and earlier in the EFT group (P = 0.0004, Wilcoxon test; P = 0.0001, log-rank test). Multivariate Cox regression analysis calculated a hazard ratio of 1.98 (P < 0.0001) for utilization of EFT. Dosing regimens of oral steroids in EFT produced no differences in the time course.



EFT strategies are advantageous for early achievement of MM-or-better-5mg. Muscle Nerve 55: 794-801, 2017.
Department of Neurology, Hanamaki General Hospital, 4-28, Kajoh-chou, Hanamaki, 025-0075, Japan.
Kimiaki
K
Utsugisawa
Department of Neurology, Hanamaki General Hospital, 4-28, Kajoh-chou, Hanamaki, 025-0075, Japan.
Yuriko
Y
Nagane
Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Tetsuya
T
Akaishi
Department of Neurology, Sendai Medical Center, Sendai, Japan.
Yasushi
Y
Suzuki
Department of Neurology, Sapporo Medical University Hospital, Sapporo, Japan.
Tomihiro
T
Imai
Department of Neurology, Sapporo Medical University Hospital, Sapporo, Japan.
Emiko
E
Tsuda
Department of Neurology, Hokkaido Medical Center, Sapporo, Japan.
Naoya
N
Minami
Department of Neurology, Chiba University School of Medicine, Chiba, Japan.
Akiyuki
A
Uzawa
Chiba Neurology Clinic, Chiba, Japan.
Naoki
N
Kawaguchi
Department of Neurology, Tokyo Medical University, Tokyo, Japan.
Masayuki
M
Masuda
Department of Neurology, Toho University Oh-hashi Medical Center, Tokyo, Japan.
Shingo
S
Konno
Department of Neurology, Kinki University School of Medicine, Osaka, Japan.
Hidekazu
H
Suzuki
Department of Neurological therapeutics, Kyushu University Graduate School of Medicine, Fukuoka, Japan.
Hiroyuki
H
Murai
Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Masashi
M
Aoki
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D007564:Japan; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000188:drug therapy*; D011239:Prednisolone / Q000627:therapeutic use*; D018709:Statistics, Nonparametric; D013997:Time Factors
D000893:Anti-Inflammatory Agents; D011239:Prednisolone
Kaplan-Meier method; myasthenia; oral steroids; treatment strategies; treatment target