Robert H P de Meel1, Alexander F Lipka2, Erik W van Zwet3, Erik H Niks4, Jan J G M Verschuuren5. 1. Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: rhpdemeel@lumc.nl. 2. Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: a.f.lipka@lumc.nl. 3. Department of Biostatistics, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: e.w.van_zwet@lumc.nl. 4. Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: e.h.niks@lumc.nl. 5. Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: j.j.g.m.verschuuren@lumc.nl.
Abstract
BACKGROUND: Disease course in myasthenia gravis (MG) patients is highly variable. Prognostic factors that identify patients at risk for a more severe disease course would be helpful in clinical practice. METHODS: We investigated MG patients under treatment at our university medical center between 1993 and 2013. The impact of baseline characteristics on the occurrence of exacerbations and the necessity of emergency treatments were investigated using multiple logistic regression analysis and log-rank tests for our Kaplan-Meier survival curves. RESULTS: We included 96 MG patients. Late age at onset (LOMG, ≥ 50 years) was associated with a higher risk of an exacerbation (odds ratio [OR]=9.33, 95% confidence interval [CI] = 2.43-35.87; p = 0.001) and the necessity of an emergency treatment within 3 years (OR = 5.25, 95% CI = 1.21-22.80; p = 0.027). The presence of additional autoimmune diseases (AID) in the patient was associated with a higher risk of an exacerbation (OR = 4.03, 95% CI = 1.09-14.85; p = 0.036). Patients with both LOMG and an additional AID had a markedly higher risk of an exacerbation (OR = 47.00, 95% CI = 6.49-340.65; p < 0.001) and the necessity of an emergency treatment (OR = 26.11, 95% CI = 4.12-165.55; p = 0.001) compared to early-onset patients without additional autoimmune diseases. CONCLUSIONS: Late-onset MG and the presence of additional autoimmune diseases were associated with a higher risk of exacerbations of MG and the necessity of emergency treatments.
BACKGROUND: Disease course in myasthenia gravis (MG) patients is highly variable. Prognostic factors that identify patients at risk for a more severe disease course would be helpful in clinical practice. METHODS: We investigated MGpatients under treatment at our university medical center between 1993 and 2013. The impact of baseline characteristics on the occurrence of exacerbations and the necessity of emergency treatments were investigated using multiple logistic regression analysis and log-rank tests for our Kaplan-Meier survival curves. RESULTS: We included 96 MGpatients. Late age at onset (LOMG, ≥ 50 years) was associated with a higher risk of an exacerbation (odds ratio [OR]=9.33, 95% confidence interval [CI] = 2.43-35.87; p = 0.001) and the necessity of an emergency treatment within 3 years (OR = 5.25, 95% CI = 1.21-22.80; p = 0.027). The presence of additional autoimmune diseases (AID) in the patient was associated with a higher risk of an exacerbation (OR = 4.03, 95% CI = 1.09-14.85; p = 0.036). Patients with both LOMG and an additional AID had a markedly higher risk of an exacerbation (OR = 47.00, 95% CI = 6.49-340.65; p < 0.001) and the necessity of an emergency treatment (OR = 26.11, 95% CI = 4.12-165.55; p = 0.001) compared to early-onset patients without additional autoimmune diseases. CONCLUSIONS: Late-onset MG and the presence of additional autoimmune diseases were associated with a higher risk of exacerbations of MG and the necessity of emergency treatments.
Authors: Christopher Nelke; Frauke Stascheit; Carmen Eckert; Marc Pawlitzki; Christina B Schroeter; Niklas Huntemann; Philipp Mergenthaler; Ercan Arat; Menekse Öztürk; Dirk Foell; Stefanie Schreiber; Stefan Vielhaber; Asmae Gassa; Henning Stetefeld; Michael Schroeter; Benjamin Berger; Andreas Totzeck; Tim Hagenacker; Sven G Meuth; Andreas Meisel; Heinz Wiendl; Tobias Ruck Journal: J Neuroinflammation Date: 2022-04-12 Impact factor: 8.322
Authors: Alexander F Lipka; Marion I Boldingh; Erik W van Zwet; Marco W J Schreurs; Jan B M Kuks; Chantal M Tallaksen; Maarten J Titulaer; Jan J G M Verschuuren Journal: Neurology Date: 2019-12-12 Impact factor: 9.910