Comparison of Conservative Treatment and Thymectomy on Myasthenia Gravis Outcome.
BACKGROUND
A systematic review of the literature was performed to compare long-term outcomes of thymectomy and medical treatment for generalized myasthenia gravis (MG).


METHODS
A Medline search through June 2015 resulted in 71 studies, 27 of which were selected (10,140 patients: 5,275 thymectomies, 4,865 medication).


RESULTS
The pooled proportion of remission with thymectomy was 0.31 (95% CI, 0.25-0.37), with conservative treatment it was 0.15 (95% CI, 0.12-0.18). The odds ratio (OR) of remission with thymectomy in comparison with medication alone was 2.44 (95% CI, 1.91-3.12) overall and according to medication type and remission definitions.


CONCLUSIONS
Thymectomy is superior to conservative treatment with solely medication on remission in MG.
Department of Population Health Science, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Policy, Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York; Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York.
Emanuela
E
Taioli
New York University, College of Arts and Science, New York, New York.
Philip Kent
PK
Paschal
Department of Population Health Science, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Policy, Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York; Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York.
Bian
B
Liu
Department of Population Health Science, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Policy, Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York; Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York.
Andrew J
AJ
Kaufman
Department of Population Health Science, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Policy, Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York; Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: raja.flores@mountsinai.org.
Raja M
RM
Flores
D000072700:Conservative Treatment; D006801:Humans; D009157:Myasthenia Gravis / Q000628:therapy*; D013934:Thymectomy; D016896:Treatment Outcome