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http://hdl.handle.net/2445/198171
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DC Field | Value | Language |
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dc.contributor.author | Cortés Vicente, Elena | - |
dc.contributor.author | Álvarez-Velasco, Rodrigo | - |
dc.contributor.author | Pla-Junca, Francesc | - |
dc.contributor.author | Rojas-Garcia, Ricard | - |
dc.contributor.author | Paradas, Carmen | - |
dc.contributor.author | Sevilla, Teresa | - |
dc.contributor.author | Casasnovas, Carlos | - |
dc.contributor.author | Gómez-Caravaca, María Teresa | - |
dc.contributor.author | Pardo, Julio | - |
dc.contributor.author | Ramos-Fransi, Alba | - |
dc.contributor.author | Pelayo-Negro, Ana Lara | - |
dc.contributor.author | Gutiérrez-Gutiérrez, Gerardo | - |
dc.contributor.author | Turon Sans, Janina | - |
dc.contributor.author | López de Munain, Adolfo | - |
dc.contributor.author | Guerrero Sola, Antonio | - |
dc.contributor.author | Jericó, Ivonne | - |
dc.contributor.author | Martín, María Asunción | - |
dc.contributor.author | Mendoza, María Dolores | - |
dc.contributor.author | Morís, Germán | - |
dc.contributor.author | Vélez-Gómez, Beatriz | - |
dc.contributor.author | García-Sobrino, Tania | - |
dc.contributor.author | Pascual-Goñi, Elba | - |
dc.contributor.author | Reyes-Leiva, David | - |
dc.contributor.author | Illa Sendra, Isabel | - |
dc.contributor.author | Gallardo, Eduard | - |
dc.date.accessioned | 2023-05-18T17:11:15Z | - |
dc.date.available | 2023-05-18T17:11:15Z | - |
dc.date.issued | 2022-01 | - |
dc.identifier.issn | 2328-9503 | - |
dc.identifier.uri | http://hdl.handle.net/2445/198171 | - |
dc.description.abstract | Objective: To describe the clinical characteristics and outcomes in patients with refractory myasthenia gravis (MG) and to determine the effectiveness and side effects of the drugs used for their treatment. Methods: This observational retrospective cross-sectional multicenter study was based on data from the Spanish MG Registry (NMD-ES). Patients were considered refractory when their MG Foundation of America post-interventional status (MGFA-PIS) was unchanged or worse after corticosteroids and two or more other immunosuppressive agents. Clinical and immunologic characteristics of drug-refractory patients, efficiency and toxicity of drugs used, and outcome (MGFA-PIS) at end of follow-up were studied. Results: We included 990 patients from 15 hospitals. Eighty-four patients (68 of 842 anti-acetylcholine receptor [AChR], 5 of 26 anti-muscle-specific tyrosine kinase [MusK], 10 of 120 seronegative, and 1 of 2 double-seropositive patients) were drug refractory. Drug-refractory patients were more frequently women (p < 0.0001), younger at onset (p < 0.0001), and anti-MuSK positive (p = 0.037). Moreover, they more frequently presented a generalized form of the disease, bulbar symptoms, and life-threatening events (p < 0.0001; p = 0.018; and p = 0.002, respectively) than non-drug-refractory patients. Mean follow-up was 9.8 years (SD 4.5). Twenty-four (50%) refractory patients had side effects to one or more of the drugs. At the end of follow-up, 42.9% of drug-refractory patients (42.6% of anti-AChR, 100% of anti-MuSK, and 10% of seronegative patients) and 79.8% of non-drug-refractory patients (p < 0.0001) achieved remission or had minimal manifestations. Eighty percent of drug-refractory-seronegative patients did not respond to any drug tested. Interpretation: In this study, 8.5% of MG patients were drug-refractory. New more specific drugs are needed to treat drug-refractory MG patients. | - |
dc.format.extent | 10 p. | - |
dc.format.mimetype | application/pdf | - |
dc.language.iso | eng | - |
dc.publisher | American Neurological Association | - |
dc.relation.isformatof | Reproducció del document publicat a: https://doi.org/10.1002/acn3.51492 | - |
dc.relation.ispartof | Annals of Clinical and Translational Neurology, 2022, vol. 9, num. 2, p. 122-131 | - |
dc.relation.uri | https://doi.org/10.1002/acn3.51492 | - |
dc.rights | cc-by-nc-nd (c) Cortés Vicente, Elena et al., 2022 | - |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/4.0/ | - |
dc.source | Articles publicats en revistes (Ciències Clíniques) | - |
dc.subject.classification | Assaigs clínics de medicaments | - |
dc.subject.classification | Malalties musculars | - |
dc.subject.classification | Immunologia | - |
dc.subject.classification | Efectes secundaris dels medicaments | - |
dc.subject.other | Drug testing | - |
dc.subject.other | Muscular Diseases | - |
dc.subject.other | Immunology | - |
dc.subject.other | Drug side effects | - |
dc.title | Drug-refractory myasthenia gravis: Clinical characteristics, treatments, and outcome | - |
dc.type | info:eu-repo/semantics/article | - |
dc.type | info:eu-repo/semantics/publishedVersion | - |
dc.identifier.idgrec | 721876 | - |
dc.date.updated | 2023-05-18T17:11:15Z | - |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | - |
dc.identifier.pmid | 35080153 | - |
Appears in Collections: | Articles publicats en revistes (Ciències Clíniques) |
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