title: Long-term efficacy and side effects of low-dose tacrolimus for the treatment of Myasthenia Gravis.
abstract: The study evaluated the efficacy of low-dose tacrolimus for treating Myasthenia Gravis (MG). Data were collected from 97 patients treated with low-dose tacrolimus from February 2011 to April 2015. Metabolic analysis was performed to determine more accurate tacrolimus dosing and patients were followed-up within clinic every 6 months for up to 4 years. The myasthenia gravis-specific activities of daily living scale was used to assess MG symptoms and their effects on patients' daily activities. All side effects and adverse reactions were thoroughly documented. At the end of follow-up, 6 patients were in complete stable remission, 17 patients were in pharmacological remission, 26 patients were in minimal manifestation status, 32 patients were improved, 2 patients were unchanged, 11 patients had worsening symptoms, and 3 patients died. Side effects were reported and/or observed in 24 patients, of which 7 patients experienced elevated blood glucose, 2 patients developed neoplasms, 3 patients developed gastrointestinal symptoms, 3 showed mild increases in aminotransferases, 3 patients suffered from bone marrow suppression, 2 patients suffered from skin rashes and erythema, and 1 patient required discontinuation of therapy. Transient renal insufficiency was also observed in 1 patient and 3 other patients had minor miscellaneous side effects. This study adds some knowledge on the efficacy and side effects of low-dose tacrolimus in the treatment of MG. Tacrolimus immunotherapy is a valid option for the management of MG, and can be gradually reduced in dose once symptoms are improved until complete withdrawal is achieved.
authors.affiliation: Department of Neurology, Chinese PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing, 100853, China.|Department of Neurology, The 309th Hospital of Chinese PLA, Beijing, 100091, China.
authors.forename: Xiaoyong
authors.initials: X
authors.lastname: Tao
authors.affiliation: Department of Neurology, The 309th Hospital of Chinese PLA, Beijing, 100091, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Neurology, The 309th Hospital of Chinese PLA, Beijing, 100091, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Jing
authors.affiliation: Department of Neurology, The 309th Hospital of Chinese PLA, Beijing, 100091, China.
authors.forename: Zhongkui
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Neurology, The 309th Hospital of Chinese PLA, Beijing, 100091, China.
authors.forename: Yuping
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Neurology, The 309th Hospital of Chinese PLA, Beijing, 100091, China.
authors.forename: Dongning
authors.initials: D
authors.lastname: Wei
authors.affiliation: Department of Neurology, Chinese PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing, 100853, China. lewish301@sina.com.
authors.forename: Xusheng
authors.initials: X
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D000359:Aftercare; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D051544:Cytochrome P-450 CYP3A / Q000235:genetics; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000188:drug therapy* / Q000235:genetics; D017063:Outcome Assessment, Health Care; D016559:Tacrolimus / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; C510164:CYP3A5 protein, human; D051544:Cytochrome P-450 CYP3A; D016559:Tacrolimus
keywords: CYP3A5; Myasthenia gravis; Neurology; Prognosis; Randomized controlled trial; Tacrolimus