Predictors of response to immunomodulation in patients with myasthenia gravis.

Abstract:

INTRODUCTION:Factors determining response to intravenous immunoglobulin (IVIg) and plasmapheresis in myasthenia gravis (MG) have not been evaluated systematically. METHODS:This study included patients treated with IVIg (n = 63) or plasmapheresis (n = 42) from two trials evaluating IVIg vs. placebo or plasmapheresis in MG. Response was defined as improvement in the quantitative myasthenia gravis score (QMGS) of ≥3.5 points at day 14. Baseline clinical, electrophysiological, and immunological factors were analyzed as predictors. RESULTS:Baseline QMGS, acetylcholine receptor antibody (AChRAb) positivity, single-fiber electromyography (SFEMG) jitter, and percent abnormal pairs and percent blocking pairs were higher in responders than in non-responders. Using multivariate logistic regression, the odds ratio for response was 13.0 (1.01-381.5) in QMGS 11-17 and 15.3 (1.34-414.3) in QMGS >17 compared with QMGS <11. CONCLUSIONS:Baseline QMGS, AChRAb positivity, and SFEMG parameters were more abnormal in patients who responded to treatment. Using multivariate regression, baseline QMGS remained as the only significant independent predictor of response.

journal_name

Muscle Nerve

journal_title

Muscle & nerve

authors

Katzberg HD,Barnett C,Bril V

doi

10.1002/mus.23236

subject

Has Abstract

pub_date

2012-05-01 00:00:00

pages

648-52

issue

5

eissn

0148-639X

issn

1097-4598

journal_volume

45

pub_type

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