Long‐Term Corticosteroid Treatment of Myasthenia Gravis

Johns, T. R.

doi:10.1111/j.1749-6632.1987.tb51325.x

Cited by 81 publications

(34 citation statements)

References 27 publications

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“…30], while improvement is reported to start earlier when high doses are used [9,31 ]. Our thera peutic regimen based on high daily doses followed by low er-dose alternate-day administration is in accordance with those reported by other authors [8,12,25].…”

Section: Discussionsupporting

confidence: 88%

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

et al. 1992

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We studied the long-term outcome of prednisone therapy in 104 patients with myasthenia gravis (MG). At the end of the follow-up period, good therapeutic results were recorded in 85 patients (81.7%), poor results in 13 (12.5 %) and no significant change of MG status in 6 (5.8%). We found a correlation between the duration of treatment and the incidence of steroid side effects. The presence of thymoma and severe forms of MG were associated with relapsing disease requiring prolonged corticosteroid regimens. The age at the start of therapy did not influence significantly the response to treatment.

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Section: Discussionsupporting

confidence: 88%

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

et al. 1992

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“…The period required to achieve a state of marked improvement ranged from 1.5 weeks to 18 months, mean 3.1 months. 58 Of relevance to the present proposal is that the frequency of 'psychological disturbance' was 3 of 129 patients or 2.3%, closely matching the figure reported in the Boston Collaborative Study. 39 Exophthalmos, pretibial myxoedema and hyperthyroidism of Graves' disease The complications of Graves' disease are presumed to be caused by variants of thyroid-stimulating autoantibodies that have a high affinity for receptors on tissue in the orbit and the shins, respectively.…”

Section: Myasthenia Gravissupporting

confidence: 85%

“…It is noteworthy that 56 patients (48%) showed an initial exacerbation, which in 8.6% was severe; occurrence of exacerbation was not related to degree of ultimate improvement. 58 This could be relevant to the finding in the cortisone trials in schizophrenia of exacerbation in some patients, resulting in early termination of the treatment. 42,43 Of the 93 myasthenic patients who responded satisfactorily, the duration of therapy to the time of maximal improvement ranged from 2 weeks to 6 years, with the median time to maximal improvement being 5.5 months.…”

Section: Myasthenia Gravismentioning

confidence: 97%

“…56 Thymectomy, corticosteroids, and other forms of immunosuppression are all useful in treatment. 57 In a study of 116 myasthenic patients treated with corticosteroids, 58 a satisfactory outcome (marked improvement or remission) was reported in 80.2%. The outcome was unsatisfactory in the remaining 19.8%, with 5.2% being unimproved and 14.7% showing only moderate improvement.…”

Section: Myasthenia Gravismentioning

confidence: 98%

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Rationale for a trial of immunosuppressive therapy in acute schizophrenia

et al. 2007

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Schizophrenia is a debilitating, costly, socially disruptive, life-threatening disease in which available treatments are largely palliative and empirical, and produce significant short-and long-term side effects. Therefore, a strong case can made for exploring alternative treatments with a rational basis for use in this disease. Considerable evidence indicates that autoimmune processes may be involved in some forms of schizophrenia, including altered risk of certain autoimmune diseases in patients and their relatives, shared epidemiological features, and apparent involvement of genes known to influence the immune response repertoire. Attempts to provide direct evidence for autoimmune processes have proven elusive, possibly due to the technical difficulty inherent in accessing autoantibodies with high affinity for brain cell-surface receptors. In view of this impasse, we argue for a well-designed trial in schizophrenia of immunosuppressive therapy, which is now the mainstay of therapy for many autoimmune diseases. Analysis of disease states in which immunosuppression has been effectively used over many decades provides guidelines necessary for a meaningful trial.

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“…The percentages of patients who showed improvement at 10 years were not different among the group 2, 3 and 4, though no patients showed remission in group 2. Although our results provide no definite evidence that thymectomy superbs the predonisolone alone at the end of following period, they are consistent with the current belief that the use of both corticosteroids and thymectomy produces a significant improvement or remission for MG patients (Mann et al 1976 ;Bolooki and Schwartzman 1978;Johns 1987).…”

Section: Discussionsupporting

confidence: 76%

Treatment of Myasthenia Gravis: A Comparison of the Natural Course and Current Therapies.

Seto

Motomura

Takeo

et al. 1993

Tohoku J. Exp. Med.

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Ninety-five patients with generalized myasthenia gravis were followed for 10 years to evaluate the long term effects of prednisolone, thymectomy, or both, and they were compared with a group only with anticholinesterase treatment. Only 15.0% of the patients with anticholinesterase alone had showed improvement 10 years after the onset, but more than 60% of those treated with prednisolone, thymectomy, or both showed improvement. Especially thymectomy induced complete remissions at 10 years after surgery in more than 20 % of the patients. There was no difference between the histology of the thymi and clinical severity, or anti-acetylcholine receptor (AChR) antibody titer. In patients who showed improvement classified "good" of higher 10 years after thymectomy with or without prednisolone, anti-AChR antibody titers swiftly decreased to 37.8% of the value before surgery, and remained low thereafter. This result suggests that the marked decrease in anti-AChR antibody titers within 1 month after thymectomy is a favorable prognostic sign in myasthenia gravis patients who have undergone thymectomy.

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Long‐Term Corticosteroid Treatment of Myasthenia Gravis

Cited by 81 publications

References 27 publications

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

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

Rationale for a trial of immunosuppressive therapy in acute schizophrenia

Treatment of Myasthenia Gravis: A Comparison of the Natural Course and Current Therapies.

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