Employment in refractory myasthenia gravis: A Myasthenia Gravis Foundation of America Registry analysis

Harris, Linda; Aban, Inmaculada; Xin, Haichang; Cutter, Gary

doi:10.1002/mus.26694

Cited by 15 publications

(15 citation statements)

References 17 publications

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“…disease severity). However, the general characteristics regarding gender and age distribution, antibody type, treatment frequencies, MG duration, MGFA Classification, and rates of patients with refractory disease are similar to previous reports, 1,7‐12,21,22,25,26,33 suggesting external validity of our findings. Although it is unknown whether gender differences influenced those who were lost during follow‐up, the statistical analyses should reduce any bias as a consequence of this.…”

Section: Discussionsupporting

confidence: 88%

Gender differences in clinical outcomes in myasthenia gravis: A prospective cohort study

et al. 2021

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Introduction/Aims It is uncertain whether clinical outcomes differ between male and female patients with myasthenia gravis (MG) while receiving standard clinical care. Methods In a prospective cohort study of 107 patients with MG receiving standard of care from 2012 to 2019, the Quantitative MG (QMG), the MG Composite (MGC), the MG Activities of Daily Living (MG‐ADL), and the MG Quality of Life 15‐Items (QOL15) were determined. Clinical outcomes were analyzed in relation to gender. Results Mean follow‐up time was 4.8 (±0.4) y, and 70 patients completed all follow‐up assessments. Patients improved on all clinical scores: QMG ‐1.8 (P < .001), MGC ‐1.5 (P < .001), MG‐ADL ‐1.3 (P < .001), and QOL15 ‐3.0 (P < .001). Females improved less than males on the QMG (P = .01), MGC (P < .001), MG‐ADL (P = .006), and QOL15 (P < .001) independent of potential confounders. Males had moderate to strong correlations between changes in all clinical scales (r range 0.52 to 0.73), whereas females had weak correlations between changes in the QMG and MG‐ADL (r = 0.13), the QMG and QOL15 (r = 0.27), the MGC and MG‐ADL (r = 0.21), the MGC and QOL15 (r = 0.00), and the MG‐ADL and QOL15 (r = 0.31). Discussion Females improved less compared to males on objective and patient‐reported outcomes. Moreover, females improved more on objective measures than on patient‐reported outcomes. These gender differences should receive attention in clinical care and in the design of future trials.

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Section: Discussionsupporting

confidence: 88%

Gender differences in clinical outcomes in myasthenia gravis: A prospective cohort study

et al. 2021

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“…The type of work also influenced QoL, patients who do hard labor had a lower QoL. This results are comparable with previous studies showing higher QoL in patients with higher vs. elementary education, white collar work vs. retirement (19,25). Our study and previous studies provide solid evidence that myasthenia is still a disabling disease, especially for patients who do hard physical work and have a lower level of education.…”

Section: Discussionsupporting

confidence: 88%

Determinants of Quality of Life in Myasthenia Gravis Patients

et al. 2020

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Background: Although approximately half of myasthenia gravis (MG) patents achieve remission, for the remaining group MG is often a lifelong disease. Better understanding of the determinants of Quality of Life (QoL) in MG is needed to optimize treatment goals in chronic cases. Materials and Methods: We performed a single center cross-sectional study in 339 MG adult patients (64.9% women), with ocular or generalized disease. SF-36 and a structured questionnaire was administered, including information on previous and current MG severity, medications, comorbidities, education, occupation and BMI of the patient. Mean disease duration was 7.5 + 9.3 years. Current age was 51.6 + 18.3 years, 55% had Early-Onset (<50 years) MG. Results: There were no statistically significant differences in mean SF-36 subscores between women and men. Worse MGFA class was related to lower QoL in physical (PCS) and mental (MCS) subscore (p = 0.000 for both). Patients with MGFA I-II class had significantly better QoL in physical and mental subscores than patients with more severe MG (p < 0.005). Late-onset MG patients had worse QoL than EOMG in physical score domain PCS (p = 0.049). Overweight and obese patients had lower PCS (p = 0.002) and MCS (p = 0.038) than patients with normal BMI. University education was related to statistically higher PCS (p = 0.015) and MCS (p = 0.006). QoL in currently employed was better in PCS and MCS (p = 0.000), with white collar workers reporting higher PCS (p = 0.049) than the remaining group. Patients living with family evaluated their MCS (p = 0.015) better than living alone. Moderate physical activity (twice a week) improved PCS (p = 0.045). Conclusion: Our study confirmed that greater severity of symptoms, age, age of onset but also BMI, type of work, education status and physical activity affect QoL in MG.

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“…Of note, the present study did not differentiate between rescue and maintenance IVIg treatment, and associated cost differences have not been investigated. Further, our study did not address the treatment-refractory patient subgroup as other recent studies have focused on examining their burden in detail ( 7 – 9 , 29 , 30 ).…”

Section: Discussionmentioning

confidence: 99%

Real-World Healthcare Resource Utilization and Cost Burden Assessment for Adults With Generalized Myasthenia Gravis in the United States

Phillips¹,

Abreu²,

Goyal³

et al. 2022

Front. Neurol.

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IntroductionLimited evidence exists for healthcare resource utilization (HCRU) and costs associated with generalized myasthenia gravis (gMG), a rare autoimmune disorder, for adults in the United States.MethodsAdults with ≥1 diagnostic claim for MG between 2014 and 2019 were identified using Symphony Health's Integrated Dataverse®. Using a novel algorithm, HCRU and costs over 12 months following index dates were evaluated for patients with gMG including those with exacerbation events. For patients who experienced crisis events, HCRU and costs were analyzed during the 36 months preceding, during, and 12 months following the events.ResultsMean HCRU and costs were higher for newly diagnosed patients compared with previously diagnosed patients (hospitalizations: 0.46 vs. 0.34; all-cause costs: $26,419.20 vs. $24,941.47; direct costs for gMG treatments: $9,890.37 vs. $9,186.47) and further increased for patients with exacerbation events (hospitalizations: 0.72; all-cause costs: $43,734.15; direct costs for gMG treatments: $21,550.02). For patients who experienced crisis events, HCRU and costs markedly increased during the 12 months immediately before the crisis event (hospitalizations: 1.35; all-cause costs: $49,236.68) compared with the 2 preceding years and increased further during the 12 months following the crisis index date (hospitalizations: 2.78; all-cause costs: $173,956.99). Cost increases were, in large part, attributed to treatments received.DiscussionNew diagnosis, exacerbation, and crisis events were drivers of HCRU and cost for patients with gMG. Particularly, high costs of gMG-specific medications associated with intervention for exacerbation and crisis events contributed to increased all-cause costs.

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Employment in refractory myasthenia gravis: A Myasthenia Gravis Foundation of America Registry analysis

Cited by 15 publications

References 17 publications

Gender differences in clinical outcomes in myasthenia gravis: A prospective cohort study

Gender differences in clinical outcomes in myasthenia gravis: A prospective cohort study

Determinants of Quality of Life in Myasthenia Gravis Patients

Real-World Healthcare Resource Utilization and Cost Burden Assessment for Adults With Generalized Myasthenia Gravis in the United States

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