Long-Term Results of Corticosteroid Therapy in Patients with Myasthenia Gravis

Evoli, Amelia; Batocchi, Anna Paola; Palmisani, M.T.; Monaco, Mauro Lo; Tonali, P.

doi:10.1159/000116785

Cited by 74 publications

(64 citation statements)

References 22 publications

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“…Based on the available evidence, approximately 70-75 % of patients treated with prednisone achieved either marked improvement or remission [38][39][40]. Prednisone is generally used when symptoms of MG are not adequately controlled by cholinesterase inhibitors alone.…”

Section: Present Management Of Autoimmune Mgmentioning

confidence: 99%

Current Treatment, Emerging Translational Therapies, and New Therapeutic Targets for Autoimmune Myasthenia Gravis

2016

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Myasthenia gravis (MG) is an autoimmune disease associated with the production of autoantibodies against 1) the skeletal muscle acetylcholine receptor; 2) muscle-specific kinase, a receptor tyrosine kinase critical for the maintenance of neuromuscular synapses; 3) low-density lipoprotein receptor-related protein 4, an important molecular binding partner for muscle-specific kinase; and 4) other muscle endplate proteins. In addition to the profile of autoantibodies, MG may be classified according the location of the affected muscles (ocular vs generalized), the age of symptom onset, and the nature of thymic pathology. Immunopathologic events leading to the production of autoantibodies differ in the various disease subtypes. Advances in our knowledge of the immunopathogenesis of the subtypes of MG will allow for directed utilization of the ever-growing repertoire of therapeutic agents that target distinct nodes in the immune pathway relevant to the initiation and maintenance of autoimmune disease. In this review, we examine the pathogenesis of MG subtypes, current treatment options, and emerging new treatments and therapeutic targets.

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Section: Present Management Of Autoimmune Mgmentioning

confidence: 99%

Current Treatment, Emerging Translational Therapies, and New Therapeutic Targets for Autoimmune Myasthenia Gravis

2016

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“…33 Vitamin D and bisphosphonates to prevent osteoporosis, and yearly evaluation for cataracts and glaucoma, have been recommended. 58 Use of steroids prior to thymectomy is discouraged by some surgeons because steroids cause involution of the thymus 47 as well as inhibition of wound healing, 87 but some patients require the relatively rapid improvement that careful prednisone treatment offers before they undergo thymectomy.…”

Section: Long-term Immunological Treatmentsmentioning

confidence: 99%

Clinical evaluation and management of myasthenia gravis

2004

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Myasthenia gravis (MG) is a syndrome of fluctuating skeletal muscle weakness that worsens with use and improves with rest. Eye, facial, oropharyngeal, axial, and limb muscles may be involved in varying combinations and degrees of severity. Its etiology is heterogeneous, divided initially between those rare congenital myasthenic syndromes, which are genetic, and the bulk of MG, which is acquired and autoimmune. The autoimmune conditions are divided in turn between those that possess measurable serum acetylcholine receptor (AChR) antibodies and a smaller group that does not. The latter group includes those MG patients who have serum antibodies to muscle-specific tyrosine kinase (MuSK). Therapeutic considerations differ for early-onset MG, late-onset MG, and MG associated with the presence of a thymoma. Most MG patients can be treated effectively, but there is still a need for more specific immunological approaches.

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“…GCs, such as prednisone, are a long-term therapeutic approach for MG and have been shown to reduce the number of circulating lymphocytes in serum to achieve improvement or remission of disease in the majority (approx. 75%) of patients [43][44][45] . In ocular MG, evidence suggests that GC treatment may delay or stop the progression to other classes of MG.…”

Section: Anti-inflammatory Therapiesmentioning

confidence: 99%

Intercommunication between the Neuroendocrine and Immune Systems: Focus on Myasthenia Gravis

Mays

Butts

2011

Neuroimmunomodulation

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Crosstalk exists between the nervous, endocrine, and immune systems, and perturbations in these interactions have been associated with disease. This includes production of neuroendocrine factors that alter immune system activity and increase susceptibility to or severity of immune-related conditions, such as myasthenia gravis (MG) – a T-cell-dependent, B-cell-mediated autoimmune disorder. MG results from impairment of transmission to the neuromuscular junction and involves the thymus – especially in early-onset disease, but the exact mechanism by which the thymus impacts disease is unclear. MG afflicts millions of individuals worldwide each year, and both men and women can develop symptoms. However, prevalence and age of onset differs between men and women. Women exhibit higher incidence and earlier age of onset compared to men, and disease fluctuates during pregnancy. This suggests that sex hormones play a role in influencing disease outcome. In this review, we will consider what is known about the manifestation of MG, theories on how different forms of MG are influenced or alleviated by steroid hormones, current treatment options, and what measures could be important to consider in the future.

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Long-Term Results of Corticosteroid Therapy in Patients with Myasthenia Gravis

Cited by 74 publications

References 22 publications

Current Treatment, Emerging Translational Therapies, and New Therapeutic Targets for Autoimmune Myasthenia Gravis

Current Treatment, Emerging Translational Therapies, and New Therapeutic Targets for Autoimmune Myasthenia Gravis

Clinical evaluation and management of myasthenia gravis

Intercommunication between the Neuroendocrine and Immune Systems: Focus on Myasthenia Gravis

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