Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2025
Clinical heterogeneity, treatment patterns, and outcomes of advanced-age-onset myasthenia gravis in China: a retrospective cohort study.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ji Ying, Zhou Shuxian, He Xiaoxiao, Li Wenbo, Zhao Xue, Zhang Yingna, Zhang Jing, Lv Jie, Liu Peipei, Cui Weike, Yang Junhong, Gao Feng
Аннотация
OBJECTIVES: The clinical characteristics and outcomes of myasthenia gravis (MG) with onset at age 50 years or older, which commonly referred to as late-onset MG (LOMG), in elderly patients remain incompletely understood. This study aimed to address the clinical heterogeneity within LOMG and to clarify whether very-late-onset MG (≥70 years) constitutes a distinct phenotype requiring tailored management approaches.
METHODS: We analyzed data from 2783 patients enrolled in the MG Registry between April 1, 2009, and December 31, 2020. Patients with LOMG were further stratified into two subgroups: those with MG onset at age 50-69 years (referred to as Early-LOMG), and those with onset at age ≥70 years (referred to as advanced-onset MG, AOMG). Clinical features, diagnostic tests, treatments, and outcomes were compared across subgroups.
RESULTS: Of the 982 patients with LOMG, 191 (19.4 %) were classified as AOMG. Compared to patients with MG onset at age 50-69 years, those with onset at age ≥70 years (AOMG) had a higher proportion of females (57.6 % vs 48.7 %, p = 0.027), and were more frequently positive for AChR-Ab (81.2 % vs 70.4 %, p = 0.001) and Titin-Ab (32.5 % vs 22.5 %, p = 0.004), and were more likely to present with bulbar muscle involvement at onset (25.3 % vs 14.8 %) and during disease progression (53.7 % vs 38.6 %). The positive rate of repetitive nerve stimulation (RNS) testing was also higher in the AOMG group (57.1 % vs 35.8 %, p = 0.018). Thymoma was less frequent (12.1 % vs 29.6 %, p = 0.006), and fewer AOMG patients underwent thymectomy (2.6 % vs 31.0 %, p < 0.001). AOMG patients generally required fewer immunosuppressive therapies and achieved comparable functional outcomes. However, the mortality rate was significantly higher in the AOMG group (p = 0.020), primarily due to MG crisis.
CONCLUSIONS: AOMG exhibits distinct clinical features compared to Early-LOMG, characterized by a higher frequency of bulbar involvement, lower thymoma prevalence, less aggressive treatment, and higher mortality. Tailored management strategies are warranted for elderly patients with MG.
METHODS: We analyzed data from 2783 patients enrolled in the MG Registry between April 1, 2009, and December 31, 2020. Patients with LOMG were further stratified into two subgroups: those with MG onset at age 50-69 years (referred to as Early-LOMG), and those with onset at age ≥70 years (referred to as advanced-onset MG, AOMG). Clinical features, diagnostic tests, treatments, and outcomes were compared across subgroups.
RESULTS: Of the 982 patients with LOMG, 191 (19.4 %) were classified as AOMG. Compared to patients with MG onset at age 50-69 years, those with onset at age ≥70 years (AOMG) had a higher proportion of females (57.6 % vs 48.7 %, p = 0.027), and were more frequently positive for AChR-Ab (81.2 % vs 70.4 %, p = 0.001) and Titin-Ab (32.5 % vs 22.5 %, p = 0.004), and were more likely to present with bulbar muscle involvement at onset (25.3 % vs 14.8 %) and during disease progression (53.7 % vs 38.6 %). The positive rate of repetitive nerve stimulation (RNS) testing was also higher in the AOMG group (57.1 % vs 35.8 %, p = 0.018). Thymoma was less frequent (12.1 % vs 29.6 %, p = 0.006), and fewer AOMG patients underwent thymectomy (2.6 % vs 31.0 %, p < 0.001). AOMG patients generally required fewer immunosuppressive therapies and achieved comparable functional outcomes. However, the mortality rate was significantly higher in the AOMG group (p = 0.020), primarily due to MG crisis.
CONCLUSIONS: AOMG exhibits distinct clinical features compared to Early-LOMG, characterized by a higher frequency of bulbar involvement, lower thymoma prevalence, less aggressive treatment, and higher mortality. Tailored management strategies are warranted for elderly patients with MG.