Details

Autor(en) / Beteiligte

• Clifford, Katherine M.
• Hobson‐Webb, Lisa D.
• Benatar, Michael
• Burns, Ted M.
• Barnett, Carolina
• Silvestri, Nicholas J.
• Howard, James F.
• Visser, Amy
• Crum, Brian A.
• Nowak, Richard
• Beekman, Rachel
• Kumar, Aditya
• Ruzhansky, Katherine
• Chen, I‐Hweii Amy
• Pulley, Michael T.
• Laboy, Shannon M.
• Fellman, Melissa A.
• Howard, Diantha B.
• Kolb, Noah A.
• Greene, Shane M.
• Pasnoor, Mamatha
• Dimachkie, Mazen M.
• Barohn, Richard J.
• Hehir, Michael K.

Titel

Thymectomy may not be associated with clinical improvement in MuSK myasthenia gravis

Ist Teil von

• Muscle & nerve, 2019-04, Vol.59 (4), p.404-410

Ort / Verlag

Hoboken, USA: John Wiley & Sons, Inc

Erscheinungsjahr

2019

Quelle

Wiley Online Library

Beschreibungen/Notizen

• ABSTRACT Introduction: A randomized trial demonstrated benefit from thymectomy in nonthymomatous acetylcholine receptor (AChR)‐antibody positive myasthenia gravis (MG). Uncontrolled observational and histologic studies suggest thymectomy may not be efficacious in anti–muscle‐specific kinase (MuSK)‐MG. Methods: The therapeutic impact of thymectomy was evaluated from data collected for a multicenter, retrospective blinded review of rituximab in MuSK‐MG. Results: Baseline characteristics were similar between thymectomy (n = 26) and nonthymectomy (n = 29) groups, including treatment with rituximab (42% vs. 45%). At last visit, 35% of thymectomy subjects reached the primary endpoint, a Myasthenia Gravis Foundation of America (MGFA) post‐intervention status (PIS) score of minimal manifestations (MM) or better, compared with 55% of controls (P = 0.17). After controlling for age at onset of MG, rituximab, prednisone, and intravenous immunoglobulin/plasma exchange treatment, thymectomy was not associated with greater likelihood of favorable clinical outcome (odds ratio = 0.43, 95% confidence interval 0.12–1.53, P = 0.19). Discussion: Thymectomy was not associated with additional clinical improvement in this multicenter cohort of MuSK‐MG patients. Muscle Nerve 59:404–410, 2019 See editorial on pages 393–394 in this issue.