Details

Autor(en) / Beteiligte

• Cortés-Vicente, Elena
• Álvarez-Velasco, Rodrigo
• Segovia, Sonia
• Paradas, Carmen
• Casasnovas, Carlos
• Guerrero-Sola, Antonio
• Pardo, Julio
• Ramos-Fransi, Alba
• Sevilla, Teresa
• López de Munain, Adolfo
• Gómez, Maria Teresa
• Jericó, Ivonne
• Gutiérrez-Gutiérrez, Gerardo
• Pelayo-Negro, Ana Lara
• Martín, María Asunción
• Mendoza, María Dolores
• Morís, Germán
• Rojas-Garcia, Ricard
• Díaz-Manera, Jordi
• Querol, Luis
• Gallardo, Eduard
• Vélez, Beatriz
• Albertí, María Antonia
• Galán, Lucía
• García-Sobrino, Tania
• Martínez-Piñeiro, Alicia
• Lozano-Veintimilla, Ana
• Fernández-Torrón, Roberto
• Cano-Abascal, Ángel
• Illa, Isabel

Titel

Clinical and therapeutic features of myasthenia gravis in adults based on age at onset

Ist Teil von

• Neurology, 2020-03, Vol.94 (11), p.e1171

Ort / Verlag

United States

Erscheinungsjahr

2020

Link zum Volltext

Beschreibungen/Notizen

• To describe the characteristics of patients with very-late-onset myasthenia gravis (MG). This observational cross-sectional multicenter study was based on information in the neurologist-driven Spanish Registry of Neuromuscular Diseases (NMD-ES). All patients were >18 years of age at onset of MG and onset occurred between 2000 and 2016 in all cases. Patients were classified into 3 age subgroups: early-onset MG (age at onset <50 years), late-onset MG (onset ≥50 and <65 years), and very-late-onset MG (onset ≥65 years). Demographic, immunologic, clinical, and therapeutic data were reviewed. A total of 939 patients from 15 hospitals were included: 288 (30.7%) had early-onset MG, 227 (24.2%) late-onset MG, and 424 (45.2%) very-late-onset MG. The mean follow-up was 9.1 years (SD 4.3). Patients with late onset and very late onset were more frequently men ( < 0.0001). Compared to the early-onset and late-onset groups, in the very-late-onset group, the presence of anti-acetylcholine receptor (anti-AChR) antibodies ( < 0.0001) was higher and fewer patients had thymoma ( < 0.0001). Late-onset MG and very-late-onset MG groups more frequently had ocular MG, both at onset (<0.0001) and at maximal worsening ( = 0.001). Although the very-late-onset group presented more life-threatening events (Myasthenia Gravis Foundation of America IVB and V) at onset ( = 0.002), they required fewer drugs ( < 0.0001) and were less frequently drug-refractory ( < 0.0001). Patients with MG are primarily ≥65 years of age with anti-AChR antibodies and no thymoma. Although patients with very-late-onset MG may present life-threatening events at onset, they achieve a good outcome with fewer immunosuppressants when diagnosed and treated properly.