RT Journal Article
SR Electronic
T1 Oral corticosteroid dosing regimen and long-term prognosis in generalised myasthenia gravis: a multicentre cross-sectional study in Japan
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 513
OP 517
DO 10.1136/jnnp-2017-316625
VO 89
IS 5
A1 Imai, Tomihiro
A1 Utsugisawa, Kimiaki
A1 Murai, Hiroyuki
A1 Tsuda, Emiko
A1 Nagane, Yuriko
A1 Suzuki, Yasushi
A1 Minami, Naoya
A1 Uzawa, Akiyuki
A1 Kawaguchi, Naoki
A1 Masuda, Masayuki
A1 Konno, Shingo
A1 Suzuki, Hidekazu
A1 Akaishi, Tetsuya
A1 Aoki, Masashi
YR 2018
UL http://jnnp.bmj.com/content/89/5/513.abstract
AB Objective We examined the correlation between the dosing regimen of oral prednisolone (PSL) and the achievement of minimal manifestation status or better on PSL ≤5 mg/day lasting >6 months (the treatment target) in patients with generalised myasthenia gravis (MG).Methods We classified 590 patients with generalised MG into high-dose (n=237), intermediate-dose (n=187) and low-dose (n=166) groups based on the oral PSL dosing regimen, and compared the clinical characteristics, previous treatments other than PSL and prognosis between three groups. The effect of oral PSL dosing regimen on the achievement of the treatment target was followed for 3 years of treatment.Results To achieve the treatment target, ORs for low-dose versus high-dose regimen were 10.4 (P<0.0001) after 1 year of treatment, 2.75 (P=0.007) after 2 years and 1.86 (P=0.15) after 3 years; and those for low-dose versus intermediate-dose regimen were 13.4 (P<0.0001) after 1 year, 3.99 (P=0.0003) after 2 years and 4.92 (P=0.0004) after 3 years. Early combined use of fast-acting treatment (OR: 2.19 after 2 years, P=0.02; OR: 2.11 after 3 years, P=0.04) or calcineurin inhibitors (OR: 2.09 after 2 years, P=0.03; OR: 2.36 after 3 years, P=0.02) was associated positively with achievement of treatment target.Conclusion A low-dose PSL regimen with early combination of other treatment options may ensure earlier achievement of the treatment target in generalised MG.