Abstract:Background: Different epidemiological studies, especially in Europe, have estimated the incidence density of myasthenia gravis (MG) to range between 1.7 and 21.3/1,000,000/person-year; however, data from regions such as Latin America are scarce. This study is aimed at estimating the incidence and prevalence of acquired MG in Buenos Aires, Argentina. Methods: The study population comprised of affiliates of the Italian Hospital Medical Care Program, a prepaid health maintenance organization located in Buenos Air… Show more
“…These data may further support the observation of a general increase in the incidence of autoimmune diseases in general and the high rate of autoimmune diseases in Israel in particular. As the pathogenesis of MG is thought to be influenced by a combination of genetic and environmental factors, 43‐45 one may speculate that our findings, also observed in other studies, 16‐18,22‐23,32‐36,38,46‐50 can be attributed to changes in environmental factors such as exposure to infective pathogens, diet, and contact with ecological compounds.…”
Section: Discussionsupporting
confidence: 86%
“…Furthermore, the occurrence of MG is influenced by sex and age: Women are affected nearly three times more than men during early adulthood (<40 years), whereas incidence is roughly equal after this age 13,14 . Also, in the last decades, MG incidence in the elderly has increased, probably due to increased awareness and increased longevity 10,15‐24 …”
Background
The incidence of myasthenia gravis (MG) has traditionally been low, ranging between 2‐6/106. Several recent epidemiological studies have reported a higher incidence. We, therefore, aimed to assess and characterize the incidence of MG in Israel.
Methods
We retrospectively reviewed the records of all four laboratories that performed the acetylcholine receptor antibody (AChR Ab) test in Israel between 1994 and 2013 and documented the number of newly diagnosed seropositive MG patients each year. To assure that data indeed reflect only newly diagnosed patients, patient's names and ID numbers were screened at the Hadassah medical center database since 1978, the year when the test was first performed in Israel. In order to calculate the annual incidence of the disease, the population at risk was derived from the annual publication of the Israeli Central Bureau of Statistics.
Results
The annual incidence of MG for this time period was 13.1/106 inhabitants. The mean incidence of MG between 1994 and 2003 was 7.695/106/y, while the mean incidence between 2004 and 2013 was 18.49/106 (P < .0001). Mean age of diagnosis between 1994 and 2003 was 56.65 ± 0.9351, while between 2004 and 2013, it was 59.89 ± 0.5336 (P = .0012). Male to female (M:F) incidence ratio in the years 1994‐2003 and 2004‐2013 was 2:3.2 and 3:1.8, respectively, reflecting increased incidence among males (P < .0001).
Conclusions
The incidence of MG in Israel has increased significantly during the last decade, especially among males of older age. These findings may reflect an etiological role of an environmental factor, increased awareness, and increased longevity in general.
“…These data may further support the observation of a general increase in the incidence of autoimmune diseases in general and the high rate of autoimmune diseases in Israel in particular. As the pathogenesis of MG is thought to be influenced by a combination of genetic and environmental factors, 43‐45 one may speculate that our findings, also observed in other studies, 16‐18,22‐23,32‐36,38,46‐50 can be attributed to changes in environmental factors such as exposure to infective pathogens, diet, and contact with ecological compounds.…”
Section: Discussionsupporting
confidence: 86%
“…Furthermore, the occurrence of MG is influenced by sex and age: Women are affected nearly three times more than men during early adulthood (<40 years), whereas incidence is roughly equal after this age 13,14 . Also, in the last decades, MG incidence in the elderly has increased, probably due to increased awareness and increased longevity 10,15‐24 …”
Background
The incidence of myasthenia gravis (MG) has traditionally been low, ranging between 2‐6/106. Several recent epidemiological studies have reported a higher incidence. We, therefore, aimed to assess and characterize the incidence of MG in Israel.
Methods
We retrospectively reviewed the records of all four laboratories that performed the acetylcholine receptor antibody (AChR Ab) test in Israel between 1994 and 2013 and documented the number of newly diagnosed seropositive MG patients each year. To assure that data indeed reflect only newly diagnosed patients, patient's names and ID numbers were screened at the Hadassah medical center database since 1978, the year when the test was first performed in Israel. In order to calculate the annual incidence of the disease, the population at risk was derived from the annual publication of the Israeli Central Bureau of Statistics.
Results
The annual incidence of MG for this time period was 13.1/106 inhabitants. The mean incidence of MG between 1994 and 2003 was 7.695/106/y, while the mean incidence between 2004 and 2013 was 18.49/106 (P < .0001). Mean age of diagnosis between 1994 and 2003 was 56.65 ± 0.9351, while between 2004 and 2013, it was 59.89 ± 0.5336 (P = .0012). Male to female (M:F) incidence ratio in the years 1994‐2003 and 2004‐2013 was 2:3.2 and 3:1.8, respectively, reflecting increased incidence among males (P < .0001).
Conclusions
The incidence of MG in Israel has increased significantly during the last decade, especially among males of older age. These findings may reflect an etiological role of an environmental factor, increased awareness, and increased longevity in general.
“…Two population-based studies from Korea showed a prevalence of 9.67–10.42 per 100,000 people in 2010, which increased to 12.99 per 100,000 in 2014 [ 17 , 18 ]. On the other hand, a smaller study using records of a hospital-based Health Maintenance Organization estimated an incidence of MG at 38.8 per 1,000,000 person-years for the Argentinian population [ 19 ]. Different study methodologies, including diagnostic criteria and other sources of bias, such as the small size of the study population and the underestimation of patients with milder disease, likely play a factor in the significant variability of incidence rates over time and across different geographical regions.…”
Myasthenia gravis (MG) is an autoimmune neurological disorder characterized by defective transmission at the neuromuscular junction. The incidence of the disease is 4.1 to 30 cases per million person-years, and the prevalence rate ranges from 150 to 200 cases per million. MG is considered a classic example of antibody-mediated autoimmune disease. Most patients with MG have autoantibodies against the acetylcholine receptors (AChRs). Less commonly identified autoantibodies include those targeted to muscle-specific kinase (MuSK), low-density lipoprotein receptor-related protein 4 (Lrp4), and agrin. These autoantibodies disrupt cholinergic transmission between nerve terminals and muscle fibers by causing downregulation, destruction, functional blocking of AChRs, or disrupting the clustering of AChRs in the postsynaptic membrane. The core clinical manifestation of MG is fatigable muscle weakness, which may affect ocular, bulbar, respiratory and limb muscles. Clinical manifestations vary according to the type of autoantibody, and whether a thymoma is present.
“…3 ). The highest prevalence was reported in Salvado et al [ 61 ]; 3463 per 100,000 population and the lowest prevalence Bettini et al [ 58 ]; 0.006 people reported per 100,000 population. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…In the current systematic review and meta-analysis study, the overall prevalence of MG in the world; 12.4 people per 100,000 population were obtained. Most prevalent in Salvado et al [ 61 ]; 3463 per 100,000 population and the lowest prevalence Bettini et al [ 58 ]; 0.006 people per 100,000 population reported.…”
Background
Myasthenia gravis is a neuromuscular autoimmune disorder characterized by weakness and disability in the voluntary muscles. There have been several preliminary studies on the epidemiology of myasthenia gravis in different parts of the world and the effectiveness of common drugs in its treatment, but there has been no comprehensive study of the efficacy of common drugs in the treatment of myasthenia gravis. Therefore, this study aimed to determine the epidemiology of myasthenia gravis globally and the effectiveness of common drugs in its treatment using systematic review and meta-analysis.
Methods
Research studies were extracted from IranDoc, MagIran, IranMedex, SID, ScienceDirect, Web of Sciences (WoS), ProQuest, Medline (PubMed), Scopus and Google Scholar based on Cochran's seven-step guidelines using existing keywords extracted in MeSH browser. The I2 test was used to calculate the heterogeneity of studies, and Begg and Mazumdar rank correlation tests were used to assess publication bias. Data were analyzed using Comprehensive Meta-Analysis software (Version 2).
Results
In the search for descriptive studies based on the research question, 7374 articles were found. After deleting articles unrelated to the research question, finally, 63 articles with a sample size of 1,206,961,907 people were included in the meta-analysis. The prevalence of MG worldwide was estimated to be 12.4 people (95% CI 10.6–14.5) per 100,000 population. For analytical studies on the effectiveness of common myasthenia gravis drugs, 4672 articles were found initially, and after removing articles unrelated to the research question, finally, 20 articles with a sample size of 643 people in the drug group and 619 people in the placebo group were included in the study. As a result of the combination of studies, the difference between the mean QMGS score index after taking Mycophenolate and Immunoglobulin or plasma exchange drugs in the group of patients showed a significant decrease of 1.4 ± 0.77 and 0.62 ± 0.28, respectively (P < 0.01).
Conclusion
The results of systematic review of drug evaluation in patients with myasthenia gravis showed that Mycophenolate and Immunoglobulin or plasma exchange drugs have positive effects in the treatment of MG. It also represents the positive effect of immunoglobulin or plasma exchange on reducing SFEMG index and QMGS index and the positive effect of Mycophenolate in reducing MG-ADL index, SFEMG and Anti-AChR antibodies index. In addition, based on a meta-analysis of the random-effect model, the overall prevalence of MG in the world is 12.4 people per 100,000 population, which indicates the urgent need for attention to this disease for prevention and treatment.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
