Gender differences in prednisone adverse effects

Abstract

ObjectivePrednisone is a first-line immunosuppressive treatment for myasthenia gravis (MG), whereas short-term and long-term adverse effects (AEs) are a limiting factor in its usage.MethodThe MG patient registry is a patient-driven, nation-wide database with patients of age ≥18 years, who were diagnosed with MG and live in the United States. Custom-designed “prednisone-steroid use and MG” survey was sent out to MG registry participants as part of semi-annual follow-up. Data were collected and analyzed for frequency.ResultsA total of 398 MG participants (21% response rate) completed the survey, including 173 men and 225 women. Among them, 298 reported current (174) or past (288) prednisone intake. Current prednisone dosage varied from 0.5 to 75 mg (median 10 mg, IQR 7–20), dosing frequency was daily in 132 (76%) and every other day in 31 (18%). Peak prednisone dose was commonly between 25 mg and 60 mg (Median 50 mg, IQR 25–60); however, doses more than 60 mg daily were reported in 59 (20%). Prednisone AEs were reported more commonly in women (95% vs 81%, p < 0.0001). Women reported more intolerable AEs (77% vs 50%, p < 0.00001) and less willingness to accept a dose increase (26% vs 44%, p = 0.03) compared with men.ConclusionsPrednisone is commonly used in the treatment of MG, with highly variable dosages and dosing frequencies reflecting the absence of a standard guideline. Intolerable AEs were more commonly reported among women and was associated with unwillingness to accept a dose increase. Consensus guidelines and their validation are required to guide prednisone treatment for MG.

Gender differences in quality of life among patients with myasthenia gravis in China

“…The survey questionnaire was translated and modified from the one used by the US Myasthenia Gravis Patient Registry [19]. The permission for translation and modification was obtained directly from the Registry.…”

“…But the mechanism underneath such gender-related differences in MG is largely unknown. The onset age, disease duration or the efficacy of treatment might interact with gender and mutually impact HRQoL of patients with MG [19].…”

Cross‐sectional analysis of the Myasthenia Gravis Patient Registry: Disability and treatment

“…The data obtained also included validated MG‐specific disease severity scales: the MG—Activities of Daily Living (MG‐ADL) and the 15‐item MG Quality of Life‐15 (MG‐QOL15) instruments . The MGR has previously identified differential gender effects of MG and its treatment in quality of life and assessment of adverse effects to prednisone treatment . Our investigation of the MGR provides an assessment of registrant demographics, treatments, and disability in a broad patient sample.…”

“…[8][9][10][11][12] The MGR has previously identified differential gender effects of MG and its treatment in quality of life and assessment of adverse effects to prednisone treatment. 13,14 Our investigation of the MGR provides an assessment of registrant demographics, treatments, and disability in a broad patient sample.…”

Diagnostic and treatment challenges, a new section in N2

“…Defining and understanding gender differences will lead to improved health care for all patients. The study by Lee et al 2 explores gender differences in the adverse effects of prednisone in a cohort of patients with myasthenia gravis. Almost 2,000 patients enrolled in the Myasthenia Gravis Registry, a nationwide database, were sent a short survey about their disease and use of steroids, and 398 patients (21%) responded.…”