Employment in Myasthenia Gravis: A Systematic Literature Review and Meta-Analysis

Abstract

Introduction: Myasthenia gravis (MG) is an autoimmune disease whose period of typical onset is around 20–40 years (i.e., early onset), thus in the peak of working age, or around 60–80 years (i.e., late onset). However, the information on work-related issues and employment status are sparse and not systematically reported. Therefore, we performed a systematic literature review with meta-analysis to address the employment status of MG patients. Methods: We searched for papers reporting employment status on participants with MG published between January 2000 and May 2019. Information on employment was extracted. Random-effects models were used to produce meta-analytic estimates for the proportion of employed patients. Results: In total, 1,045 records were retrieved, of which 19 fitted the inclusion criteria. In total, 3,600 participants (average age 47.5, range 35–60) were included in the studies and 1,579 of them were employed. The proportion of employed patients varied from 28 to 82%, with an extreme heterogeneity between studies. Overall, the pooled proportion of workers was 50% (95% CI 41–60%). Subgroup analyses suggested a possible, although not significant, higher proportion of workers among women, younger participants, those with a higher level of education, shorter MG duration, and less frequently thymectomized, whereas a lower proportion was observed among those with generalized, bulbar, and respiratory symptoms. Conclusions: The results of our meta-analysis show that the percentage of employment is considerably low if we take into account that the mean age of MG patients involved in the included studies was around 48 years, thus in peak of working life. Therefore, it is important to understand what kind of influence MG exerts on work dynamics.

Physician-Reported Perspectives on Myasthenia Gravis in the United States: A Real-World Survey

“…Some of these over-the-counter medications, such as quinine and magnesium, have been shown in some instances to exacerbate MG [ 36 ]. In addition, the mean age at diagnosis was relatively high compared with the expected age of MG onset, [ 37 , 38 ]. Thus, it is possible that a subgroup analysis of a younger population with fewer comorbidities may have yielded different results.…”

Analysis of the Influence of Hybrid Personalized Recommendation Algorithm on the Employment Tendency of Hotel Management Major

“…Literature [10] holds that intention refers to the intention and tendency that an individual has consciously planned to pursue or not pursue a specific goal to some extent. Literature [11] also puts forward that intention is the antecedent of behavior. Literature [12] verified that internship job satisfaction, internship job stress, and students' intention to choose jobs in hotel industry were significantly positively correlated and negatively correlated and discussed the regression model of students' intention to choose jobs in hotel industry.…”

Academic and Employment Status in Patients With Generalized Myasthenia Gravis Treated With Eculizumab: A Case Series

“… 23 Moreover, in a meta-analysis of data from 3600 patients with MG, only 50% were in employment, which is low considering that the average age was ∼48 years. 17 In addition to the impact on the individual's socioeconomic status, the consequences of reduced productivity (presenteeism), absenteeism, or early retirement place a burden on society in terms of indirect costs, including disability benefits and costs incurred via the Family and Medical Leave Act in the USA. Published data on this topic are sparse.…”

“…In adults, it has been shown that MG can have a negative impact on work performance and lead to unemployment, premature retirement, and reduced income. [17][18][19] However, there is a lack of data on the impact of MG treatments on work-related outcomes. Eculizumab, a terminal complement inhibitor indicated in the USA for adults with anti-AChR antibody-positive gMG, 20,21 has been shown to improve patients' abilities to conduct everyday activities.…”