Muscle & nerve · 2018
Myasthenic ophthalmoparesis: Time To resolution after initiating immune therapies.
СтатьяНаблюдательное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Europa Tarin A, Nel Melissa, Heckmann Jeannine M
Аннотация
INTRODUCTION: Although immunotherapies such as prednisone are effective in treating myasthenic muscle weakness, their effect on resolution of myasthenic-induced persistent ophthalmoparesis is unknown.
METHODS: We observed patients with myasthenia gravis during their first year of immunotherapy, documenting ophthalmoplegia scores and drug doses.
RESULTS: Seventy-six of 87 cases had persistent ophthalmoparesis. With immunotherapy, the median time to resolution of ophthalmoparesis was 7 months, and 37% of cases resolved within 3 months. Patients starting therapy within 12 months of symptom onset were twice as likely to have resolution in the first year (P = 0.028). Resolution of ophthalmoparesis within 3 months, compared with later resolution, was associated with higher initial prednisone doses (mean 0.5 vs. 0.3 mg/kg/day; P = 0.014). However, 25% of the higher dose group also received intravenous immunoglobulin/plasma exchange; after their exclusion, the finding was not significant.
DISCUSSION: One-third of cases with myasthenic ophthalmoparesis resolved within 3 months of immunotherapy, particularly in response to more aggressive immunotherapy. Muscle Nerve 58: 542-549, 2018.
METHODS: We observed patients with myasthenia gravis during their first year of immunotherapy, documenting ophthalmoplegia scores and drug doses.
RESULTS: Seventy-six of 87 cases had persistent ophthalmoparesis. With immunotherapy, the median time to resolution of ophthalmoparesis was 7 months, and 37% of cases resolved within 3 months. Patients starting therapy within 12 months of symptom onset were twice as likely to have resolution in the first year (P = 0.028). Resolution of ophthalmoparesis within 3 months, compared with later resolution, was associated with higher initial prednisone doses (mean 0.5 vs. 0.3 mg/kg/day; P = 0.014). However, 25% of the higher dose group also received intravenous immunoglobulin/plasma exchange; after their exclusion, the finding was not significant.
DISCUSSION: One-third of cases with myasthenic ophthalmoparesis resolved within 3 months of immunotherapy, particularly in response to more aggressive immunotherapy. Muscle Nerve 58: 542-549, 2018.