Comparison of outcomes and postoperative immunotherapy between patients with non-thymomatous and thymomatous myasthenia gravis following thymectomy

• Published in: Therapeutic advances in neurological disorders Vol. 18; p. 17562864251343573
• Main Authors: Zhang, Qing, Pan, XuanXuan, Bi, Zhuajin, Zhan, Jiayang, Yang, Mengge, Lin, Jing, Gui, Mengcui, Li, Zhijun, Zhang, Min, Ma, Xue, Bu, Bitao
• Format: Journal Article
• Language: English
• Published: England SAGE Publications 01.01.2025; SAGE Publishing
• Subjects: Original Research; myasthenia gravis; thymectomy; non-thymoma; thymoma; immunotherapy
• ISSN: 1756-2864; 1756-2856; 1756-2864
• DOI: 10.1177/17562864251343573

Comparing outcomes and postoperative treatment after thymectomy for two types of myasthenia gravis Why was the study done? Myasthenia gravis (MG) is an immune-mediated disorder characterized by muscle fatigue and fluctuating weakness. MG can be classified into two types: non-thymomatous MG (without thymus tumors) and thymomatous MG (with thymus tumors). This study aimed to examine the treatment and prognosis of these two types of MG and see if certain interventions after thymectomy can help improve recovery. What did the researchers do? The researchers conducted a study that included 284 patients (142 with non-thymomatous MG and 142 with thymomatous MG) who underwent thymectomy between November 2010 and January 2024. The study compared the postoperative prognoses between the two groups of patients following thymectomy, with a particular focus on evaluating the role of postoperative immunosuppressive therapy. What did the researchers find? The study found that non-thymomatous MG had better outcomes after thymectomy, as evidenced by fewer severe episodes (called myasthenic crisis), lower long-term mortality, and a higher rate of sustained improvement than thymomatous MG. Both non-thymomatous and thymomatous MG patients who tested positive for a specific antibody (AChR-Ab) had better recovery. However, thymoma patients with more severe MG before surgery and high-grade histopathology were at higher risk of problems after surgery. The combination of prednisone and tacrolimus after surgery was associated with better long-term outcomes for both groups of patients. What do the findings mean? The findings suggested that non-thymomatous MG exhibited a more benign course with better outcomes. AChR-Ab positivity indicated a more favorable prognosis for both groups. Thymomatous MG patients with severe conditions and high-grade histopathology require enhanced management and follow-up. Additionally, using prednisone and tacrolimus could be a good treatment option for MG after thymectomy.