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Exacerbation Rate in Generalized Myasthenia Gravis and Its Predictors
European Neurology ( IF 2.4 ) Pub Date : 2020-12-15 , DOI: 10.1159/000512077
Ahmad R Abuzinadah 1, 2 , Mohammed H Alanazy 3 , Nadeem S Butt 4 , Richard J Barohn 5 , Mazen M Dimachkie 5
Affiliation  

OBJECTIVE The aim of the study was to estimate the exacerbation incidence rate (IR) in acetylcholine receptor antibody (AChR)-positive generalized myasthenia gravis (MG) and its predictors. METHODS The primary outcome in this retrospective study was to estimate moderate-to-severe (M-S) exacerbations IR in the early course of generalized MG. The secondary outcome was to explore the predictors of MG exacerbations. RESULTS Between 1999 and 2015, we identified 78 AChR-positive generalized MG patients and 37 M-S exacerbations over the first 6 years following the onset of generalized MG symptoms. The M-S exacerbation IR was 12.2 per 100 person years (95% confidence interval [CI] 8.8-16.8). Any exacerbation (including mild) IR was 24.4 per 100 person years (95% CI 19.4-30.7). After controlling for confounding factors, MG exacerbation IR predictors included gender, disease severity at onset, and prednisone dose reduction with risk ratio of 0.34 (male gender), 2.67, and 20.8, respectively (all p values <0.05). M-S exacerbation occurred in 25 cases (32.1%), while any exacerbation (mild or M-S) was detected in 45 cases (57.7%). CONCLUSION More than half of newly diagnosed AChR + MG cases experience an exacerbation in the first 6 years. Gender, disease severity at onset and prednisone dose reduction are predictors that could inform clinical practice and future research.

中文翻译:

全身性重症肌无力的恶化率及其预测因素

目的 本研究的目的是评估乙酰胆碱受体抗体 (AChR) 阳性全身性重症肌无力 (MG) 的急性加重发生率 (IR) 及其预测因子。方法 这项回顾性研究的主要结果是评估全身 MG 早期过程中的中度至重度 (MS) 加重 IR。次要结果是探索 MG 恶化的预测因素。结果 1999 年至 2015 年间,我们确定了 78 名 AChR 阳性全身性 MG 患者和 37 名全身性 MG 症状出现后前 6 年的 MS 恶化。MS 加重 IR 为 12.2/100 人年(95% 置信区间 [CI] 8.8-16.8)。任何恶化(包括轻度)IR 为 24.4/100 人年(95% CI 19.4-30.7)。控制混杂因素后,MG 加重 IR 预测因子包括性别、发病时的疾病严重程度和泼尼松剂量减少,风险比分别为 0.34(男性)、2.67 和 20.8(所有 p 值 <0.05)。MS 恶化发生在 25 例 (32.1%) 中,而在 45 例 (57.7%) 中检测到任何恶化(轻度或 MS)。结论 超过一半的新诊断的 AChR + MG 病例在前 6 年经历了恶化。性别、发病时的疾病严重程度和泼尼松剂量的减少是可以为临床实践和未来研究提供信息的预测因素。结论 超过一半的新诊断的 AChR + MG 病例在前 6 年经历了恶化。性别、发病时的疾病严重程度和泼尼松剂量的减少是可以为临床实践和未来研究提供信息的预测因素。结论 超过一半的新诊断的 AChR + MG 病例在前 6 年经历了恶化。性别、发病时的疾病严重程度和泼尼松剂量的减少是可以为临床实践和未来研究提供信息的预测因素。
更新日期:2020-12-15
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