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Long‐term effects of combined immunosuppressive treatment on myasthenic crisis
Author(s) -
Rózsa C.,
Mikor A.,
Kasa K.,
Illes Z.,
Komoly S.
Publication year - 2009
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/j.1468-1331.2009.02634.x
Subject(s) - medicine , mechanical ventilation , myasthenia gravis , azathioprine , prednisolone , anesthesia , gastroenterology , surgery , disease
Background and purpose: We studied the long‐term crisis‐preventing effect of combined prednisolone‐azathioprine (PR‐AZA) treatment in myasthenia gravis (MG). Methods: Case–control study with a median follow‐up of 64 months in the treated group, and 80 months in the non‐treated group. Sixty‐nine patients with episodes of myasthenic crisis (MC) were treated and followed prospectively in 1990–2004. Twenty‐seven patients had MC between 1990 and 1996, and were not treated with immunosuppressants on long‐term. Long‐term PR‐AZA treatment was introduced in another 42 patients, who developed MC in 1997–2004. The difference in the frequency of repeated MCs between the treated and the non‐treated group during long‐term follow‐up was investigated. As secondary end‐points, we analyzed the number of admittances to the ICU; the number of mechanical ventilation episodes; the duration of ICU treatment; the characteristics of the applied treatment; and the functional outcome of the patients 1 month after the onset of the crisis. Results: Recurrent MCs occurred in 74% of the non‐treated and 19% of the treated group ( P < 0.001). The number of ICU admissions ( P = 0.005) and mechanical ventilation events ( P = 0.002) were also reduced. The highly significant MC preventing effect of PR‐AZA was evident after 6 months. Conclusions: After the initial 6 months of therapy, PR‐AZA is effective in preventing MC .