A nationwide epidemiological study of myasthenia gravis in Latvia

Zieda, Anete; Rāviņa, Kristīne; Glazere, I.; Pelcere, L.; Naudina, M.S.I.; Liepiņa, Lelde; Kamsa, I.; Kurjāne, Nataļja; Woodhall, Mark; Jacobson, Leslie; Leite, M I; Tandon, Kokil; Ķēniņa, Viktorija

doi:10.1111/ene.13535

Cited by 27 publications

(17 citation statements)

References 21 publications

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“…Despite an increasing number of epidemiological studies on MG [7][8][9][10][11][12] , only a handful of studies have addressed the disease course [13 , 14] , especially regarding overall mortality rates [15][16][17][18] and cause of death [19] in MG patients. Some studies have focused on deaths due to respiratory failure and myasthenic crisis in particular [20][21][22][23][24][25][26][27] .…”

Section: Introductionmentioning

confidence: 99%

Mortality rates and causes of death in Swedish Myasthenia Gravis patients

Westerberg

Punga

2020

Neuromuscular Disorders

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Myasthenia Gravis (MG) is an autoimmune disease with several comorbidities, however information on MG mortality remains sparse. We conducted a nationwide register-based study on mortality rates and causes of death among Swedish MG patients. Data was acquired from four Swedish National Board of Health and Welfare registers. A total of 4559 MG patients (2522 women, 55.3%) being alive entering the year 2006, were identified. 1121 patients (562 women, 50.1%) died during 2006-2016. Age-and gender-standardized mortality rate was 1.51 (95% CI 0.40) per 100 patients and did not differ from the Swedish general population. Time from MG diagnosis to death was 8.9 ± 6.8 years. The most common ultimate cause of death was cancer (19.5%), followed by ischemic heart disease (13.3%) and MG (11.3%). When MG was stated as the ultimate cause of death, there was a strikingly higher likelihood of having influenza/pneumonia as a contributing cause of death (OR 2.5, p < 0.0001). In conclusion, although we could not confirm a higher mortality rate in Swedish MG patients compared to the general population, and despite modern advancements in treatment, we observed that MG itself was stated as the third most common ultimate cause of death in Swedish MG patients.

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Section: Introductionmentioning

confidence: 99%

Mortality rates and causes of death in Swedish Myasthenia Gravis patients

Westerberg

Punga

2020

Neuromuscular Disorders

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“…MG is usually caused by production of autoimmune antibodies to acetylcholine receptors or other proteins required for neuromuscular transmission 4 and initially presents as weaknesses of the extraocular muscles, resulting in double or blurred vision and ptosis 4,5 . Approximately 75% of patients with MG develop generalized disease with bulbar and limb weakness [6][7][8] , which can cause difficulties eating, drinking, speaking, walking, driving and breathing 9,10 . MG can be exacerbated by a variety of factors and, at least once in their lives, 15-20% of patients with MG will have a myasthenic crisis in which they will experience respiratory failure requiring intubation and mechanical ventilation 11,12 .…”

Section: Introductionmentioning

confidence: 99%

Healthcare resource utilization by patients with treatment-refractory myasthenia gravis in England

Harris

Graham²,

MacLachlan³

et al. 2019

Journal of Medical Economics

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Aims: To examine healthcare resource utilization associated with refractory myasthenia gravis (MG) in England. Materials and methods: This was a retrospective cohort study of linked data from the Clinical Practice Research Datalink and the Hospital Episode Statistics database collected between 1997 and 2016. Included patients were !18 years of age at the index MG diagnosis. Patients with refractory MG were identified using an algorithm based on treatments received. Healthcare resource utilization since the index date was compared between refractory and non-refractory cohorts. Results: The study included 1149 patients with MG, of whom 66 (5.7%) were refractory. Sex and age at diagnosis did not significantly differ between the refractory and non-refractory cohorts. Rates of healthcare resource utilization per person-year were significantly higher (p < .05) for patients with refractory compared to non-refractory MG for GP visits, visits to other healthcare professionals, outpatient visits and inpatient hospitalization. Patients in the refractory cohort spent more total days hospitalized since the index visit than patients in the non-refractory cohort (median, 33 vs. 16 days [p < .0001]). Limitations: The algorithm for identifying refractory patients did not include clinical criteria. Also, treatments administered in hospitals or by specialists were not available in the databases. Conclusions: Patients in England with refractory MG more often visit healthcare providers, are hospitalized and visit an emergency room than patients with non-refractory MG.

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“…Two main observations emerge from these findings: The incidence of late‐onset AChR Ab‐positive MG significantly increased during the past decade and is responsible in large part for the overall increase in incidence in our study. This increased incidence of MG in the elderly has also been observed in other geographical areas during the past two decades 10,15‐20,23‐24,29,35‐38 The incidence ratio of AChR Ab‐positive MG between male and female patients (M:F) has also changed from the first to the second decade.…”

Section: Discussionmentioning

confidence: 57%

“…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 …”

Section: Introductionmentioning

confidence: 99%

Incidence of AChR Ab‐positive myasthenia gravis in Israel: A population‐based study

et al. 2020

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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.

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A nationwide epidemiological study of myasthenia gravis in Latvia

Abstract: This is the first study of MG in Latvia and the second population-based study of MG in Eastern Europe. Our epidemiological results are similar to those in some other European and Northern American countries, and show high prevalence and increasing incidence of late-onset MG.

Cited by 27 publications

References 21 publications

Mortality rates and causes of death in Swedish Myasthenia Gravis patients

Mortality rates and causes of death in Swedish Myasthenia Gravis patients

Healthcare resource utilization by patients with treatment-refractory myasthenia gravis in England

Incidence of AChR Ab‐positive myasthenia gravis in Israel: A population‐based study

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