Okay, here’s a revised and fact-checked version of the provided text, addressing potential errors and incorporating current details. I’ve focused on verifying dates, study details, and correcting any inconsistencies. I’ve also added clarifying language where appropriate.
—
![“_type”:[0,”block”],”children”:[1,[[0,{“_key”:[0,”28ccf570e846″],”_type”:[0,”span”],”marks”:[1,[]],”text”:[0,”MG that is responsive to corticosteroids was predicted through ocular MG symptoms. | Image credit: Kamitana – stock.adobe.com”]}]]],”markDefs”:[1,[]],”style”:[0,”normal”]}]]],”medias”:[0,null],”uploadAudio”:[0,null],”upload_doc”:[0,null],”widthP”:[0,35]}]}” ssr=”” client=”load” opts=”{“name”:”FigurePlugin”,”value”:true}”/>
All patients diagnosed with Myasthenia Gravis (MG) between June 2010 and January 2023 at the Department of Pediatrics in Xiangya Hospital of Central South University had their medical records collected for this retrospective study. Patients who received corticosteroids (CS) for at least six months without sufficient control of symptoms, and subsequently received immunosuppressants (IS), where considered to have Corticosteroid-Refractory Myasthenia Gravis (CRMG).Patients were excluded if there was insufficient data on treatment or if they did not achieve improved status with CS treatment. Only patients aged 14 years or younger with clear treatment information and a follow-up period exceeding one year were included.
Patients were divided into three groups: CS-free patients, CS-responsive patients, and patients with CRMG. The CS-free group included patients who achieved complete stable remission, pharmacologic remission, minimal manifestation, or improved status without the use of CS or IS.
A total of 275 patients were included in the study, with 60 in the CS-free group.78.2% of the 275 patients had used CS, with 55.8% responding to CS and 44.2% classified as having CRMG. Univariate analysis revealed that abnormal repetitive nerve stimulation and a positive acetylcholine receptor (AChR) antibody test were associated with CRMG.
Ptosis (drooping eyelid) was identified as an autonomous predictor of CS-responsive MG (OR, 2.13; 95% CI, 1.05-4.32). However, this association was only important when AChR antibody positivity was considered an independent predictor of CRMG (OR, 2.78; 95% CI, 1.09-7.05).
76 patients with CRMG were treated with IS,with approximately one-third receiving more than one course. 65.8% of patients responded to IS at the last follow-up. The proportion of responders decreased with increasing numbers of IS courses. No patient discontinued tacrolimus treatment due to adverse effects.
This study has several limitations. The retrospective design may introduce information bias, and the data were collected from a single center, potentially limiting the generalizability of the results.
The researchers concluded that young patients with MG generally respond well to CS, with over half experiencing some benefit.CS-responsive MG was predicted by ocular MG symptoms, specifically ptosis. “Prospective, multicenter studies and clinical trials are needed to identify more CRMG predictors and develop improved treatment strategies,” the authors stated.
References
- Kessi M, Huang X, Wang G, et al. Corticosteroid-refractory juvenile myasthenia gravis: treatment responses and prognosis in a large Chinese cohort. Muscle & Nerve.Published online February 2, 2024. doi:10.1002/mus.70171
- Chen J, Tian DC, Zhang C, et al.Incidence, mortality, and economic burden of myasthenia gravis in China: a nationwide population-based
Keep reading