Journal of neuroimmunology · 2026
Thymectomy promotes maintained complete stable remission in myasthenia gravis.
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Zhang Nana, Chen Hongxi, Mo Yuntao, Wang Rui, Wang Xiaofei, Shi Ziyan, Zhang Ying, Du Qin, Zhang Yangyang, Kong Lingyao, Mou Zichao, Huang Linyue, Yasinjan Feroza, Zhang Zhiyu, Zhou Hongyu
Аннотация
AIMS: This study aimed to evaluate the impact of thymectomy on the long-term prognosis of myasthenia gravis (MG) patients, using maintainable complete stable remission (mCSR) as the primary outcome.
METHODS: We performed a retrospective analysis of prospectively collected data from the MG database at West China Hospital. mCSR was defined as the cessation of all MG-related treatments with symptom-free status for at least 1 year until the last follow-up. Kaplan-Meier curves and multivariable Cox proportional hazards model were used to assess thymectomy's effect on mCSR.
RESULTS: A total of 421 MG patients were included, with a median disease duration of approximately 10 years. A higher proportion of thymectomy patients achieved mCSR compared to the conservative treatment group (20/164 [12.2%] vs. 11/257 [4.3%], p = 0.002). Subgroup analysis showed thymectomy significantly predicted mCSR in early-onset MG (HR = 4.61, 95% CI: 1.83-11.63, p = 0.001), females (HR = 2.68, 95% CI: 1.11-6.48, p = 0.028), and ocular MG patients (HR = 3.03, 95% CI: 1.27-7.19, p = 0.012). After adjusting for age, sex, and baseline classification (ocular or generalized), thymectomy remained an independent predictor of mCSR in both the overall cohort (HR = 3.40, 95% CI: 1.61-7.19, p = 0.001) and non-thymomatous MG subgroup (HR = 5.56, 95% CI: 2.35-13.2, p < 0.001). In ocular MG, thymectomy was also associated with a higher mCSR rate (16.7% vs. 5.7%, p = 0.008).
DISCUSSION: Thymectomy is beneficial for MG patients in achieving mCSR, including ocular and non-thymomatous subgroups.
METHODS: We performed a retrospective analysis of prospectively collected data from the MG database at West China Hospital. mCSR was defined as the cessation of all MG-related treatments with symptom-free status for at least 1 year until the last follow-up. Kaplan-Meier curves and multivariable Cox proportional hazards model were used to assess thymectomy's effect on mCSR.
RESULTS: A total of 421 MG patients were included, with a median disease duration of approximately 10 years. A higher proportion of thymectomy patients achieved mCSR compared to the conservative treatment group (20/164 [12.2%] vs. 11/257 [4.3%], p = 0.002). Subgroup analysis showed thymectomy significantly predicted mCSR in early-onset MG (HR = 4.61, 95% CI: 1.83-11.63, p = 0.001), females (HR = 2.68, 95% CI: 1.11-6.48, p = 0.028), and ocular MG patients (HR = 3.03, 95% CI: 1.27-7.19, p = 0.012). After adjusting for age, sex, and baseline classification (ocular or generalized), thymectomy remained an independent predictor of mCSR in both the overall cohort (HR = 3.40, 95% CI: 1.61-7.19, p = 0.001) and non-thymomatous MG subgroup (HR = 5.56, 95% CI: 2.35-13.2, p < 0.001). In ocular MG, thymectomy was also associated with a higher mCSR rate (16.7% vs. 5.7%, p = 0.008).
DISCUSSION: Thymectomy is beneficial for MG patients in achieving mCSR, including ocular and non-thymomatous subgroups.