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Mycophenolate mofetil in AChR‐antibody‐positive myasthenia gravis: Outcomes in 102 patients
Author(s) -
Hehir Michael K.,
Burns Ted M.,
Alpers Joshua,
Conaway Mark R.,
Sawa Michael,
Sanders Donald B.
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.21640
Subject(s) - prednisone , myasthenia gravis , medicine , acetylcholine receptor , gastroenterology , randomized controlled trial , surgery , receptor
Abstract Two recent randomized, controlled trials failed to demonstrate a benefit of mycophenolate mofetil (MMF) over prednisone in the treatment of myasthenia gravis (MG). We reviewed our experience with MMF in MG to determine whether these trials may have been unsuccessful because of their short duration and the unpredicted benefit of prednisone. We reviewed outcomes and prednisone dosage for all our acetylcholine‐receptor (AChR)‐antibody positive MG patients treated with MMF alone or with prednisone for at least 3 months. The percentage of patients with a desirable outcome (MG‐specific Manual Muscle Test score <4 or Myasthenia Gravis Foundation of America post‐invention status of minimal manifestations or better) began to increase after 6 months; 80% of those followed for >24 months had a desirable outcome. Prednisone dose decreased after 12 months; after 25 months, 54.5% of patients took no prednisone and 75% took <7.5 mg/day. This retrospective analysis provides class IV evidence that MMF begins to improve AChR‐positive MG after 6 months, both with prednisone and as monotherapy. Muscle Nerve 41: 593–598, 2010