Ivo Bozovic1, Jelena Ilic Zivojinovic2, Stojan Peric1, Marko Kostic3, Vukan Ivanovic1, Dragana Lavrnic1, Ivana Basta4. 1. Faculty of Medicine, Neurology Clinic, University Clinical Center of Serbia, University of Belgrade, 6, Dr. Subotic Sr. Street, 11 000, Belgrade, Serbia. 2. Faculty of Medicine, Institute of Hygiene and Medical Ecology, University of Belgrade, Belgrade, Serbia. 3. Faculty of Medicine, Clinic for Thoracic Surgery, University Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia. 4. Faculty of Medicine, Neurology Clinic, University Clinical Center of Serbia, University of Belgrade, 6, Dr. Subotic Sr. Street, 11 000, Belgrade, Serbia. iv.obozovic@gmail.com.
Abstract
INTRODUCTION: Even treated, myasthenia gravis (MG) continues to represent a significant burden and might continuously affect patients' quality of life (QoL). The aim of our longitudinal study was to analyze QoL in a large cohort of MG patients after a 10-year follow-up period. METHODS: This study comprised 78 MG patients (60% females, 50 ± 16 years old at baseline, 70% AchR positive) who were retested after 10 years. Disease severity was evaluated by MGFA classification. QoL was assessed using SF-36 questionnaire and Myasthenia Gravis-specific Questionnaire (MGQ). Hamilton rating scales for depression and anxiety (HDRS and HARS), Multidimensional Scale of Perceived Social Support (MSPSS) and Acceptance of Illness Scale (AIS) were also used. RESULTS: Similar percentage of patients was in remission at both time points (42% and 45%). However, at baseline all patients were treated, while 32% were treatment-free at follow-up. SF-36, MGQ, MSPSS and AIS scores were similar at baseline and retest. Mean HDRS and HARS scores worsened during time (p < 0.05), although percentage of patients with depression and anxiety did not change significantly. Significant predictors of worse SF-36 score at retest were depression (β = - 0.45, p < 0.01), poor disease acceptance (β = - 0.44, p < 0.01) and older age (β = - 0.30, p < 0.01). Significant predictors of worse MGQ score at retest were poor disease acceptance (β = - 0.40, p < 0.01), retirement (β = - 0.36, p < 0.01), lower education (β = 0.25, p < 0.01), and depression (β = - 0.18, p < 0.05). CONCLUSIONS: Although after 10 years, a significant number of MG patients were in remission, their QoL was still reduced. Neurologists should be aware that patients' perception of poor QoL may persist even if MG is well treated from a physician's perspective.
INTRODUCTION: Even treated, myasthenia gravis (MG) continues to represent a significant burden and might continuously affect patients' quality of life (QoL). The aim of our longitudinal study was to analyze QoL in a large cohort of MG patients after a 10-year follow-up period. METHODS: This study comprised 78 MG patients (60% females, 50 ± 16 years old at baseline, 70% AchR positive) who were retested after 10 years. Disease severity was evaluated by MGFA classification. QoL was assessed using SF-36 questionnaire and Myasthenia Gravis-specific Questionnaire (MGQ). Hamilton rating scales for depression and anxiety (HDRS and HARS), Multidimensional Scale of Perceived Social Support (MSPSS) and Acceptance of Illness Scale (AIS) were also used. RESULTS: Similar percentage of patients was in remission at both time points (42% and 45%). However, at baseline all patients were treated, while 32% were treatment-free at follow-up. SF-36, MGQ, MSPSS and AIS scores were similar at baseline and retest. Mean HDRS and HARS scores worsened during time (p < 0.05), although percentage of patients with depression and anxiety did not change significantly. Significant predictors of worse SF-36 score at retest were depression (β = - 0.45, p < 0.01), poor disease acceptance (β = - 0.44, p < 0.01) and older age (β = - 0.30, p < 0.01). Significant predictors of worse MGQ score at retest were poor disease acceptance (β = - 0.40, p < 0.01), retirement (β = - 0.36, p < 0.01), lower education (β = 0.25, p < 0.01), and depression (β = - 0.18, p < 0.05). CONCLUSIONS: Although after 10 years, a significant number of MG patients were in remission, their QoL was still reduced. Neurologists should be aware that patients' perception of poor QoL may persist even if MG is well treated from a physician's perspective.
Authors: Ivo Bozovic; Aleksandra Kacar; Stojan Peric; Ana Nikolic; Bogdan Bjelica; Mina Cobeljic; Milutin Petrovic; Aleksandar Stojanov; Vanja Djuric; Miroslav Stojanovic; Gordana Djordjevic; Vesna Martic; Aleksandra Dominovic; Zoran Vukojevic; Ivana Basta Journal: J Neurol Date: 2017-10-30 Impact factor: 4.849
Authors: Gil I Wolfe; Henry J Kaminski; Inmaculada B Aban; Greg Minisman; Hui-Chien Kuo; Alexander Marx; Philipp Ströbel; Claudio Mazia; Joel Oger; J Gabriel Cea; Jeannine M Heckmann; Amelia Evoli; Wilfred Nix; Emma Ciafaloni; Giovanni Antonini; Rawiphan Witoonpanich; John O King; Said R Beydoun; Colin H Chalk; Alexandru C Barboi; Anthony A Amato; Aziz I Shaibani; Bashar Katirji; Bryan R F Lecky; Camilla Buckley; Angela Vincent; Elza Dias-Tosta; Hiroaki Yoshikawa; Márcia Waddington-Cruz; Michael T Pulley; Michael H Rivner; Anna Kostera-Pruszczyk; Robert M Pascuzzi; Carlayne E Jackson; Jan J G M Verschuuren; Janice M Massey; John T Kissel; Lineu C Werneck; Michael Benatar; Richard J Barohn; Rup Tandan; Tahseen Mozaffar; Nicholas J Silvestri; Robin Conwit; Joshua R Sonett; Alfred Jaretzki; John Newsom-Davis; Gary R Cutter Journal: Lancet Neurol Date: 2019-01-25 Impact factor: 44.182
Authors: Ivana Z Basta; Tatjana D Pekmezović; Stojan Z Perić; Darija B Kisić-Tepavčević; Vidosava M Rakočević-Stojanović; Zorica D Stević; Dragana V Lavrnić Journal: Neurol Sci Date: 2012-08-09 Impact factor: 3.307
Authors: I Basta; T Pekmezović; L Padua; V Stojanović; Z Stević; A Nikolić; S Perić; D Lavrnić Journal: Acta Neurol Scand Date: 2009-12-10 Impact factor: 3.209
Authors: M I Boldingh; L Dekker; A H Maniaol; C Brunborg; A F Lipka; E H Niks; J J G M Verschuuren; C M E Tallaksen Journal: Health Qual Life Outcomes Date: 2015-08-01 Impact factor: 3.186