Comparisons of maximum severity, achievement of MM-or-better-5mg for ≥6 months and other treatments in patients classified by oral PSL dosing regimen
| High-dose group (n=237) | Intermediate-dose group (n=187) | Low-dose group (n=166) | P value | |
| Maximum severity through the entire course | ||||
| MGFA clinical classification (%)(II/III/IV/V) | 37.8/27.7/12.2/22.3* | 51.9/35.3/3.7/9.1 | 72.4/22.2/0.6/4.8 | <0.0001* |
| Worst QMG score (range) | 18.6±7.9 (3–39)† | 14.4±6.4 (1–39) | 13.9±6.3 (4–39) | <0.0001† |
| Achievement of MM-or-better-5mg for ≥6 months | ||||
| After 1 year of treatment (%) | 9.6 | 11.4 | 52.1* | <0.0001* |
| After 2 years of treatment (%) | 29.9 | 30.8 | 61.2* | <0.0001* |
| After 3 years of treatment (%) | 44.1 | 36.4 | 64.1* | <0.0001* |
| Previous treatments other than PSL | ||||
| Accumulated dose of HMP (g), range | 12.9±25.8 (0–157.5)† | 17.7±22.2 (0–135) | 23.1±37.8 (0–318)† | 0.01† |
| PE/PP (%) | 43.7 | 30.3* | 40.7 | 0.02* |
| Intravenous Ig (%) | 19.3 | 26.7 | 20.4 | 0.16 |
| EFT (%) | 31.4* | 39.8* | 53.6* | <0.0001* |
| Early use of CNIs (%) | 12.2* | 29.8* | 47.1* | <0.0001* |
EFT is use of fast-acting therapy such as PP, often combined with HMP, HMP alone or intravenous Ig within 6 months of treatment initiation.
*Pearson’s Χ2 test.
†Significant difference detected by one-way ANOVA followed by the Tukey-Kramer test.
ANOVA, analysis of variance; CNIs, calcineurin inhibitors; EFT, early fast-acting treatment; HMP, high-dose intravenous methylprednisolone; Ig, immunoglobulin; MGFA, Myasthenia Gravis Foundation of America; MM-or-better-5mg for ≥6 months, minimal manifestation status or better on prednisolone ≤5 mg/day lasting ≥6 months (the treatment target); PE, plasma exchange; PP, plasmapheresis; PSL, prednisolone; QMG, quantitative myasthenia gravis.