Abstract:
INTRODUCTION:A randomized trial demonstrated benefit from thymectomy in nonthymomatous acetylcholine receptor (AChR)-antibody positive myasthenia gravis (MG). Uncontrolled observational and histologic studies suggest thymectomy may not be efficacious in anti-muscle-specific kinase (MuSK)-MG. METHODS:The therapeutic impact of thymectomy was evaluated from data collected for a multicenter, retrospective blinded review of rituximab in MuSK-MG. RESULTS:Baseline characteristics were similar between thymectomy (n = 26) and nonthymectomy (n = 29) groups, including treatment with rituximab (42% vs. 45%). At last visit, 35% of thymectomy subjects reached the primary endpoint, a Myasthenia Gravis Foundation of America (MGFA) post-intervention status (PIS) score of minimal manifestations (MM) or better, compared with 55% of controls (P = 0.17). After controlling for age at onset of MG, rituximab, prednisone, and intravenous immunoglobulin/plasma exchange treatment, thymectomy was not associated with greater likelihood of favorable clinical outcome (odds ratio = 0.43, 95% confidence interval 0.12-1.53, P = 0.19). DISCUSSION:Thymectomy was not associated with additional clinical improvement in this multicenter cohort of MuSK-MG patients. Muscle Nerve 59:404-410, 2019.
journal_name
Muscle Nervejournal_title
Muscle & nerveauthors
Clifford KM,Hobson-Webb LD,Benatar M,Burns TM,Barnett C,Silvestri NJ,Howard JF Jr,Visser A,Crum BA,Nowak R,Beekman R,Kumar A,Ruzhansky K,Chen IA,Pulley MT,Laboy SM,Fellman MA,Howard DB,Kolb NA,Greene SM,Pasnoor Mdoi
10.1002/mus.26404subject
Has Abstractpub_date
2019-04-01 00:00:00pages
404-410issue
4eissn
0148-639Xissn
1097-4598journal_volume
59pub_type
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