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Factors associated with response to calcineurin inhibitors in myasthenia gravis
Author(s) -
Nagane Yuriko,
Suzuki Shigeaki,
Suzuki Norihiro,
Utsugisawa Kimiaki
Publication year - 2010
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.21462
Subject(s) - calcineurin , myasthenia gravis , medicine , thymoma , repetitive nerve stimulation , prednisolone , tacrolimus , odds ratio , logistic regression , autoantibody , endocrinology , gastroenterology , immunology , transplantation , antibody
The objective was to assess which clinical factors of patients with myasthenia gravis (MG) are associated with responsiveness to calcineurin inhibitors (CNIs, cyclosporine and tacrolimus). We retrospectively analyzed the 6‐month effects of CNIs in 62 MG patients. We excluded the influence of other immune treatments and determined factors associated with response to CNIs. The frequency of patients who achieved neither a ≥3‐point reduction in quantitative MG score nor a ≥25% reduction in daily dose of prednisolone (poor responders) reached 35.5% (22/62) and 64.5% (40/62), respectively, compared with patients who achieved at least one of these improvements (responders). Neither dose nor blood concentration of CNIs differed between groups. Multivariate logistic regression analysis revealed time since onset of disease [odds ratio (OR) = 0.85, P = 0.005] and presence of thymoma (OR = 5.56, P = 0.05) as clinical factors that predict response to CNIs. As for MG‐related autoantibody status, an autoantibody against a voltage‐gated potassium channel, Kv1.4, was associated with response (OR = 9.01, P = 0.04) and showed a correlation with the presence of thymoma ( P < 0.01). In MG, the early stages of disease and thymoma‐associated MG are responsive to treatment with CNIs. Muscle Nerve, 2010