Docetaxel/cisplatin therapy in myasthenia gravis with hypertension/diabetes

Abstract

<jats:title>Abstract</jats:title><jats:sec id="j_med-2017-0058_s_005_w2aab2b8d175b1b7b1aab1c15b1Aa"><jats:title>Background</jats:title><jats:p>Therapeutic options for thymoma-associated myasthenia gravis (MG) patients complicated with hypertension and/or diabetes post thymectomy are often conventional steroids. As the prevalence of diabetes and hypertension globally increases, other therapeutic options for these patients are of great importance.</jats:p></jats:sec><jats:sec id="j_med-2017-0058_s_006_w2aab2b8d175b1b7b1aab1c15b2Aa"><jats:title>Material/methods</jats:title><jats:p>9 patients with thymoma-associated MG complicated with hypertension and/or diabetes after thymectomy were administered 75 mg/m2 of docetaxel and 70 mg/m2 of cisplatin on day 1. The treatment could be repeated at 3-week intervals, ranging from 1 to 4 cycles according to the status of the patients. Therapeutic efficacy and side effects were evaluated.</jats:p></jats:sec><jats:sec id="j_med-2017-0058_s_007_w2aab2b8d175b1b7b1aab1c15b3Aa"><jats:title> Results</jats:title><jats:p>2 patients were complicated with type 2 diabetes, 6 with hypertension, and 1 with both diabetes and hypertension. After docetaxel/cisplain therapy, the MG symptoms were markedly improved in all patients (2, complete remission; 3, basic remission; 3, marked improvement; 1, improvement). Acetylcholine receptor (AchR) antibody levels were decreased in 8 patients. Minor adverse effects were observed in 2 patients, 1 with Grade II gastrointestinal reaction, and the other with pulmonary infection.</jats:p></jats:sec><jats:sec id="j_med-2017-0058_s_008_w2aab2b8d175b1b7b1aab1c15b4Aa"><jats:title>Conclusion</jats:title><jats:p>Docetaxel plus cisplatin might be an effective therapeutic option for thymoma-associated MG patients complicated with hypertension /diabetes post thymectomy without worsening thymoma and hypertension / diabetes.</jats:p></jats:sec>

Assessment of the risks of a myasthenic crisis after thymectomy in patients with myasthenia gravis: a systematic review and meta-analysis of 25 studies

“…Then, 62 records were excluded by reading the full texts. Finally, data from 3728 individual patients with 692 myasthenic crisis cases were included in the meta-analysis of 25 eligible studies [ 1 , 7 , 8 , 14 – 36 ]. Figure 1 presents the literature search and study selection process.…”

“…Myasthenia gravis (MG) is an autoimmune disorder induced by neurotransmission defects at the neuromuscular junction and is characterized by muscle weakness and fatigue [1]. MG is typically treated with anticholinesterase agents, surgical thymectomy, or immunosuppression and with short-term immunotherapies (plasmapheresis and intravenous immunoglobulin administration) to reduce the risk of exacerbations [2].…”

Identification of Potential Serum Protein Biomarkers in Thymoma with Myasthenia Gravis After Docetaxel Treatment

“…However, most chemotherapy drugs for patients with TMG do not relieve MG symptoms and even may make them worse. Previous studies reported the efficacy of docetaxel in thymic epithelial tumors [14], and our preliminary study showed that docetaxel could significantly alleviate MG symptoms in patients with TMG [15,16]. The serum is used to measure AChR antibody concentrations and is also used for other studies in patients with MG, such as serum metabolomic profiling [17] and expression levels of several interleukins [18,19].…”