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Long-term outcome in patients with myasthenia gravis: one decade longitudinal study

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Abstract

Introduction

Even treated, myasthenia gravis (MG) continues to represent a significant burden and might continuously affect patients’ quality of life (QoL). The aim of our longitudinal study was to analyze QoL in a large cohort of MG patients after a 10-year follow-up period.

Methods

This study comprised 78 MG patients (60% females, 50 ± 16 years old at baseline, 70% AchR positive) who were retested after 10 years. Disease severity was evaluated by MGFA classification. QoL was assessed using SF-36 questionnaire and Myasthenia Gravis-specific Questionnaire (MGQ). Hamilton rating scales for depression and anxiety (HDRS and HARS), Multidimensional Scale of Perceived Social Support (MSPSS) and Acceptance of Illness Scale (AIS) were also used.

Results

Similar percentage of patients was in remission at both time points (42% and 45%). However, at baseline all patients were treated, while 32% were treatment-free at follow-up. SF-36, MGQ, MSPSS and AIS scores were similar at baseline and retest. Mean HDRS and HARS scores worsened during time (p < 0.05), although percentage of patients with depression and anxiety did not change significantly. Significant predictors of worse SF-36 score at retest were depression (β = − 0.45, p < 0.01), poor disease acceptance (β = − 0.44, p < 0.01) and older age (β = − 0.30, p < 0.01). Significant predictors of worse MGQ score at retest were poor disease acceptance (β = − 0.40, p < 0.01), retirement (β = − 0.36, p < 0.01), lower education (β = 0.25, p < 0.01), and depression (β = − 0.18, p < 0.05).

Conclusions

Although after 10 years, a significant number of MG patients were in remission, their QoL was still reduced. Neurologists should be aware that patients’ perception of poor QoL may persist even if MG is well treated from a physician’s perspective.

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Availability of data and material

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy and ethical restrictions.

Code availability

Not applicable.

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Funding

This study was supported by the Ministry of Education, Science and Technological Development of Serbia (grant #175083).

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Authors and Affiliations

  1. Faculty of Medicine, Neurology Clinic, University Clinical Center of Serbia, University of Belgrade, 6, Dr. Subotic Sr. Street, 11 000, Belgrade, Serbia

    Ivo Bozovic, Stojan Peric , Vukan Ivanovic, Dragana Lavrnic & Ivana Basta

  2. Faculty of Medicine, Institute of Hygiene and Medical Ecology, University of Belgrade, Belgrade, Serbia

    Jelena Ilic Zivojinovic

  3. Faculty of Medicine, Clinic for Thoracic Surgery, University Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia

    Marko Kostic

Authors
  1. Ivo Bozovic
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  2. Jelena Ilic Zivojinovic
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  3. Stojan Peric
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  4. Marko Kostic
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  5. Vukan Ivanovic
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  6. Dragana Lavrnic
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  7. Ivana Basta
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by JIZ, IB, MK, VI and SP. The first draft of the manuscript was written by IB and SP, and all authors have commented on previous versions of the manuscript. The whole research was conceptualized and supervised by IB, DL and SP. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Ivana Basta.

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The authors declare that they have no conflict of interest.

Ethics approval

This research was approved by the Ethical Committee of the Faculty of Medicine, University of Belgrade (decision 2650/x-11).

Consent to participate

Informed consent was obtained from all individual participants included in the study.

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Each author has read and approved the final manuscript version for submission.

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Bozovic, I., Ilic Zivojinovic, J., Peric , S. et al. Long-term outcome in patients with myasthenia gravis: one decade longitudinal study. J Neurol 269, 2039–2045 (2022). https://doi.org/10.1007/s00415-021-10759-4

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  • DOI: https://doi.org/10.1007/s00415-021-10759-4

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