BMC neurology · 2026
Patient-reported health utility in adults with myasthenia gravis: a systematic review and meta-analysis of EQ-5D outcomes.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Budumuri Venkata Siva Karthik, G Akshaya Kamalashree, Murugadoss Hariharan, Arun Vasanth, Basheer Aneesh
Аннотация
BACKGROUND: Myasthenia gravis (MG) is a chronic autoimmune neuromuscular disorder associated with impaired health-related quality of life. EQ-5D utility and EQ-VAS scores are used in health economic evaluations, but reported estimates vary across MG populations, instruments, tariffs, and study designs.
METHODS: We systematically searched PubMed, Embase, Scopus, and CENTRAL from inception to February 2026. Observational studies and randomized controlled trials reporting baseline or pre-intervention EQ-5D utility or EQ-VAS data in adults with MG were included. Random-effects meta-analyses used restricted maximum likelihood estimation. Subgroup, sensitivity, GRADE-informed certainty, and exploratory aggregate-level meta-regression analyses were performed.
RESULTS: Ten studies were included. Eight studies (n = 1,514) contributed to EQ-5D utility synthesis, yielding a descriptive pooled mean of 0.74 (95% CI 0.68-0.80), with very high heterogeneity (I² = 95.4%; Cochran Q p < 0.001) and a wide prediction interval (0.52-0.96). Seven studies (n = 2,760) contributed to EQ-VAS synthesis, with a descriptive pooled mean of 66.49 (95% CI 60.99-71.99), very high heterogeneity (I² = 96.3%; Cochran Q p < 0.001), and a wide prediction interval (47.70-85.28). Sensitivity analysis excluding the RCT baseline dataset did not materially change the pooled EQ-5D estimate. In an exploratory analysis based on two studies, utility declined across Myasthenia Gravis Foundation of America (MGFA) classes I-IV. Exploratory meta-regression suggested a possible negative association between mean disease duration and utility, but certainty was very low.
CONCLUSION: EQ-5D and EQ-VAS estimates indicate impaired patient-reported health status in MG, but pooled values should be interpreted as low-certainty descriptive summaries, not definitive utility inputs.
METHODS: We systematically searched PubMed, Embase, Scopus, and CENTRAL from inception to February 2026. Observational studies and randomized controlled trials reporting baseline or pre-intervention EQ-5D utility or EQ-VAS data in adults with MG were included. Random-effects meta-analyses used restricted maximum likelihood estimation. Subgroup, sensitivity, GRADE-informed certainty, and exploratory aggregate-level meta-regression analyses were performed.
RESULTS: Ten studies were included. Eight studies (n = 1,514) contributed to EQ-5D utility synthesis, yielding a descriptive pooled mean of 0.74 (95% CI 0.68-0.80), with very high heterogeneity (I² = 95.4%; Cochran Q p < 0.001) and a wide prediction interval (0.52-0.96). Seven studies (n = 2,760) contributed to EQ-VAS synthesis, with a descriptive pooled mean of 66.49 (95% CI 60.99-71.99), very high heterogeneity (I² = 96.3%; Cochran Q p < 0.001), and a wide prediction interval (47.70-85.28). Sensitivity analysis excluding the RCT baseline dataset did not materially change the pooled EQ-5D estimate. In an exploratory analysis based on two studies, utility declined across Myasthenia Gravis Foundation of America (MGFA) classes I-IV. Exploratory meta-regression suggested a possible negative association between mean disease duration and utility, but certainty was very low.
CONCLUSION: EQ-5D and EQ-VAS estimates indicate impaired patient-reported health status in MG, but pooled values should be interpreted as low-certainty descriptive summaries, not definitive utility inputs.