Comorbidities worsen the prognosis of generalized myasthenia gravis post-thymectomy

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http://hdl.handle.net/10138/334377

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Laakso , S M , Myllynen , C , Strbian , D & Atula , S 2021 , ' Comorbidities worsen the prognosis of generalized myasthenia gravis post-thymectomy ' , Journal of the Neurological Sciences , vol. 427 , 117549 . https://doi.org/10.1016/j.jns.2021.117549

Title: Comorbidities worsen the prognosis of generalized myasthenia gravis post-thymectomy
Author: Laakso, Sini M.; Myllynen, Chris; Strbian, Daniel; Atula, Sari
Contributor: University of Helsinki, TRIMM - Translational Immunology Research Program
University of Helsinki, Neurologian yksikkö
University of Helsinki, HUS Neurocenter
Date: 2021-08-15
Language: eng
Number of pages: 6
Belongs to series: Journal of the Neurological Sciences
ISSN: 0022-510X
URI: http://hdl.handle.net/10138/334377
Abstract: Background: The effect of comorbidities on the prognosis of myasthenia gravis (MG) remains unclear. In particular, the role of other autoimmune diseases (AD) is controversial. Methods: In this retrospective single-center cohort study, we investigated 154 consecutive generalized thymectomized MG patients, with a mean follow-up time of 8.6 (+/- 5.0) years post-thymectomy. Comorbidities diagnosed at any timepoint were retrieved from medical records and Charlson comorbidity index (CCI) scores were calculated. Patients were categorized into subgroups MG alone (n = 45) and MG with any comorbidity (n = 109); the latter was further categorized into MG with other ADs (n = 33) and MG with non-AD comorbidities (n = 76). The endpoints analyzed were complete stable remission (CSR), minimal need for medications, and need for inhospital treatments. Results: CSR was more frequent in MG alone than in MG with any comorbidity group (26.7% vs 8.3%, p = 0.004). Minimal need for medication was reached more often in the MG alone than in the MG with non-AD comorbidities group (p = 0.047). Need for in-hospital treatments was lower in the MG alone group than in MG patients with any comorbidity (p = 0.046). Logistic regression analysis revealed that lower CCI scores increased the likelihood of CSR (p = 0.033). Lower CCI scores were more prevalent both in patients with minimal need for medication and in patients who did not need in-hospital treatments (p < 0.001). Conclusions: Patients with generalized MG and comorbidities have a poorer prognosis than patients with MG alone during almost 9 years follow-up after thymectomy. AD comorbidities appeared not to translate into a higher risk compared to other comorbidities.
Subject: Myasthenia gravis
Thymectomy
Comorbidity
Prognosis
Neuroimmunological disease
Treatment
GERMINAL-CENTERS
REMISSION
INDEX
SCORE
3112 Neurosciences
3124 Neurology and psychiatry
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