Determinants of quality of life in Brazilian patients with myasthenia gravis

Mourão, Aline Mansueto; Gómez, Rodrigo Santiago; Barbosa, Luiz C. A.; Freitas, Denise da Silva; Comini-Frota, Elizabeth Regina; Kümmer, Arthur; Lemos, Stela Maris Aguiar; Teixeira, Antônio Lúcio

doi:10.6061/clinics/2016(07)03

Cited by 12 publications

(6 citation statements)

References 29 publications

(50 reference statements)

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“…More recently, MG-specific quality of life instruments, including the 60-item MG quality of life scale (MG-QOL60) [9], a shortened version of MG-QOL-60, MG-QOL15 [10], and its revised version, MG-QOL15r [11], have become increasingly popular for measuring MG patients' physical and psychological functions. According to studies where MG specific HRQoL instruments were applied, factors including the severity of disease, dose of prednisone, levels of anxiety and depression could have impact on MG patients' well-beings as well [12,13].…”

Section: Introductionmentioning

confidence: 99%

Gender differences in quality of life among patients with myasthenia gravis in China

Dong

Chong

et al. 2020

Health Qual Life Outcomes

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Background: Myasthenia gravis (MG), a chronic neuromuscular disorder, can adversely affect patients' healthrelated quality of life (HRQoL), especially in women. The study aimed to evaluate the difference in HRQoL of women and men MG patients and explore the factors that mediate the relationship between gender and HRQoL. Methods: A cross-sectional study was conducted among 1815 patients with MG in China. The revised 15-item MG quality of life scale (MG-QOL15r) was used to access patients' HRQoL in overall, physical, social and emotional domains. Socio-demographic information, diagnosis and treatment history, comorbidities, social support, active lifestyle and the MG activities of daily living scale (MG-ADL) were recorded and compared between women and men using the Student's t-test and Pearson's Chi-square test. Multivariable regression analyses were conducted to identify independent contributors to HRQoL, especially those affecting different gender. Results: On average, female patients with MG reported a lower MG-QOL15r score than the males (44.49 ± 29.10 vs 49.32 ± 29.18). The association between gender and patients' HRQoL interacted with the number of comorbidities across the overall, physical and social domains of patients. As the number of comorbidities increased, the scores of HRQoL decreased and it was faster among females than the males (p < 0.05). Moreover, unemployment, exacerbation of the disease, and active lifestyle contributed to the patients' HRQoL across all domains. Unemployment (β = − 4.99 [95%CI, − 7.80 to − 2.18], p < 0.001) and exacerbations (β = − 8.49 [95%CI, − 11.43 to − 5.54], p < 0.001) were correlated with poorer HRQoL; while an active lifestyle had a positive impact on HRQoL (β = 0.28 [95%CI, 0.16 to 0.40], p < 0.001). Conclusions: The results indicate that the HRQoL of women MG patients was lower than that of men. The relationship between gender and HRQoL is modulated by the number of comorbidities. Thus, to improve the HRQoL of women MG patients, symptomatic treatments might not be enough, their comorbid conditions should be considered as well. Additionally, employment status, MG exacerbations, and an active lifestyle have been found as determining factors of the patients' HRQoL, which suggests future interventions should cope with these factors to improve their quality of life.

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Section: Introductionmentioning

confidence: 99%

Gender differences in quality of life among patients with myasthenia gravis in China

Dong

Chong

et al. 2020

Health Qual Life Outcomes

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“…But in 2012, Basta IZ and colleagues [7] noted that the comparison of QOL scores in thymectomized and non-thymectomized patients showed no significant differences. Also, Mourão AM and colleagues [8] searched the determinants of quality of life in Brazilian patients with myasthenia gravis, and found that there was no difference in QOL between thymectomized and non-thymectomized patients.…”

Section: Discussionmentioning

confidence: 99%

“…Many variables may impact QOL in MG patients such as demographic variables such as age and gender; clinical variables such as disease duration, main symptoms, MG classification, and treatments; and anxiety and depressive symptoms [8].…”

Section: Introductionmentioning

confidence: 99%

Determinants of quality of life changes with plasmapheresis in patients with myasthenia gravis

Al-Ahmer

Elshony

2021

Egypt J Neurol Psychiatry Neurosurg

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Background Immunomodulation, including IVIG and plasma exchange, is useful for a crisis or severe exacerbation. Plasma exchange may be slightly faster and more effective in a myasthenic crisis than IVIG. The aim of the current study was to determine the changes in the quality of life (QOL) after plasmapheresis and factors influencing these changes. Results This study was conducted on 98 MG patients diagnosed as moderate to severe myasthenia gravis (according to Myasthenia Gravis Foundation of America classification), 81 patients received alternate day 5 sessions plasmapheresis (TPE group) and 17 patients were on medical treatment only (control group). All patients were subjected to full history, through clinical neurological evaluation and scored with quantitative myasthenia gravis (QMG) score for MG severity at start and after 1 m. Both groups completed the QOL questionnaire at baseline and after 1 month. The MG-QOL-15 scores were computed and we analyzed the change in the QOL scores from baseline to after plasmapheresis groups and compared it with the results for the control group. The scores in QOL scales had significantly decreased after plasmapheresis, and the improvement in QOL scores had a good correlation with the decrease in QMGS. The improvement in QOL and QMG was significantly correlated with younger age, female gender, shorter duration of the illness, presence of AchR antibodies, antibody titer, and thymus hyperplasia. Conclusion Plasmapheresis is effective in improving quality of life in myasthenia gravis patients and this improvement influenced by age, gender, duration of illness, presence of AchR antibodies and their titer, and the thymus pathology.

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“…Furthermore, this, steroid may be partly responsible for the depression in MG ( 78 ). This hypothesis is exemplified by Suzuki's study in which 287 cases of MG were recruited to investigate the factors underlying depressive states in MG ( 54 ).…”

Section: Etiologymentioning

confidence: 99%

Depressive Syndromes in Autoimmune Disorders of the Nervous System: Prevalence, Etiology, and Influence

Liu

Tang

2018

Front. Psychiatry

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Autoimmune diseases of the nervous system (ADNS) consist of a group of severely disabling disorders characterized by abnormal immune attack against protein components of the nervous system. This type of attack behavior may occur in the central or peripheral nervous system, and in the neuromuscular junction, resulting in neuronal damage, axonal injury, demyelination or destruction of the neuromuscular junction. While the neurological deficits of patients with ADNS have received significant research attention, the manifestation of depression tends to be ignored. In fact, depressive manifestation is common in ADNS and adds significant burden upon patients suffering from this disease. Here, we systematically reviewed the current literature to highlight the prevalence, etiology and influence of depressive manifestation in ADNS. Most autoimmune diseases of the nervous system are discussed in this paper, from multiple sclerosis, acute disseminated encephalomyelitis and autoimmune encephalitis to acute myelitis, neuromyelitis optica, Guillain-Barré syndrome and myasthenia gravis. Depressive symptoms usually develop as a comorbidity during the course of disease, but sometimes exist as a primary presentation of the disease. Psychosocial factors, long periods of disablement and chronic pain are the three most common causes of depressive symptoms in many chronic conditions, particularly in peripheral neuropathy. Furthermore, the higher prevalence of depressive symptoms in ADNS suggests that immunological dysregulation may contribute to the elevated morbidity of depression. Finally, structural lesions of the brain, and some medications for ADNS, are also thought to precipitate depressive states in ADNS.

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Determinants of quality of life in Brazilian patients with myasthenia gravis

Cited by 12 publications

References 29 publications

Gender differences in quality of life among patients with myasthenia gravis in China

Gender differences in quality of life among patients with myasthenia gravis in China

Determinants of quality of life changes with plasmapheresis in patients with myasthenia gravis

Depressive Syndromes in Autoimmune Disorders of the Nervous System: Prevalence, Etiology, and Influence

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