Intravenous methylprednisolone therapy for ocular myasthenia gravis: A retrospective study

IF 0.4 Q4 CLINICAL NEUROLOGY Neurology and Clinical Neuroscience Pub Date : 2024-03-29 DOI:10.1111/ncn3.12810
S. Yorozu, Jinsoo Koh, Katsuichi Miyamoto, M. Sakata, Y. Nakayama, Maiko Takahashi, Megumi Mori, Junko Taruya, Takuya Matsumoto, Mai Minamino, Shuhei Ogami, Mayako Niwa, Y. Hiwatani, Y. Kajimoto, H. Ishiguchi, Hidefumi Ito
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Abstract

Although intravenous methylprednisolone pulse (IVMP) therapy has been recommended for ocular myasthenia gravis (OMG), the evidence is limited.We aimed to investigate the efficacy and safety of IVMP for OMG.The patients with OMG were chosen retrospectively from May 2010 to December 2022. The therapeutic effects between IVMP‐treated and non‐IVMP‐treated groups were determined by ∆ocular quantitative MG (QMG) score and the ∆ocular MG activities of daily living profile (MG‐ADL) score, which is the disparities of the scores between before and after 1 month of drug administration; and Myasthenia Gravis Foundation of America post‐intervention status at 1, 3, 6, and 12 months.There were 26 patients with OMG included, with the mean age of 67.2 ± 13.1 years. 13 of the 26 people with OMG received IVMP and subsequent low‐dose immunotherapies. The ∆ocular QMG and ∆ocular MG‐ADL scores were significantly higher in the IVMP group of 3 (1.5, 4) and 3 (2, 4.5) than in the non‐IVMP group of 1.5 (0, 3) and 1 (0, 2), p = 0.038 and p = 0.0027, respectively. The rates of minimal manifestation or better status in post‐intervention status at 1 and 12 months were also considerably higher in the IVMP group of 77% and 92% compared with the non‐IVMP group of 0% and 23%, p = 0.0001 and 0.001. There were no serious side effects discovered.IVMP induction therapy can quickly and safely improve symptoms of OMG, and subsequent low‐dose immunotherapy can keep symptoms at bay for 12 months.
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眼肌萎缩症的甲基强的松龙静脉注射疗法:一项回顾性研究
尽管静脉甲基强的松龙脉冲(IVMP)疗法已被推荐用于眼肌萎缩症(OMG),但证据有限。IVMP治疗组和非IVMP治疗组的疗效通过∆眼部定量MG(QMG)评分和∆眼部MG日常生活活动档案(MG-ADL)评分(即用药1个月前后的评分差异)以及美国肌无力基金会干预后1、3、6和12个月的状况来确定。26名OMG患者中有13人接受了IVMP和随后的低剂量免疫疗法。IVMP组的∆眼QMG和∆眼MG-ADL评分分别为3(1.5,4)和3(2,4.5),明显高于非IVMP组的1.5(0,3)和1(0,2),p=0.038和p=0.0027。在干预后的 1 个月和 12 个月,IVMP 组的症状表现极轻或更好的比例也大大高于非 IVMP 组,分别为 77% 和 92%,而非 IVMP 组分别为 0% 和 23%,p = 0.0001 和 0.001。没有发现严重的副作用。IVMP诱导疗法可以快速、安全地改善OMG症状,随后的低剂量免疫疗法可以在12个月内控制症状。
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