The Myasthenia Gravis Activities of Daily Living score and associated factors to distinguish the refractory phase in generalized myasthenia gravis patients with 5 years or more disease duration

• Published in: Rinsho Shinkeigaku Vol. 62; no. 12; pp. 915 - 921
• Main Authors: Sugimoto, Takamichi, Yamawaki, Takemori, Naito, Hiroyuki, Ohno, Narumi, Giga, Mayumi, Kono, Tomoyuki, Ochi, Kazuhide, Kohriyama, Tatsuo, Nomura, Eiichi, Maruyama, Hirofumi
• Format: Journal Article
• Language: Japanese
• Published: Japan Societas Neurologica Japonica 17.12.2022
• Subjects: fast-acting treatment; postintervention status; refractory; fast-acting treatment; postintervention status; refractory
• ISSN: 0009-918X; 1882-0654
• DOI: 10.5692/clinicalneurol.cn-001790

Associated factors of the Myasthenia Gravis Activities of Daily Living (MG-ADL) score were investigated in 55 patients who had had generalized MG for more than 5 years. In multivariate analysis, correlates of the MG-ADL score at the last follow-up were the total number of fast-acting treatments (FTs) (standardized regression coefficient 0.617，P < 0.001) and Myasthenia Gravis Foundation of America (MGFA) classification (standardized regression coefficient 0.227，P = 0.032) (F = 32.7，P < 0.001). In patients with a score of 5 or more on MG-ADL at the last follow-up, tendency as follows were seen: 1) early-onset (P = 0.002), 2) longer duration (P = 0.014), 3) high frequency of MGFA classification V (P = 0.017), 4) high frequency of the total number of FTs (P < 0.001), and 5) higher dose of prednisolone at the last follow-up (P = 0.003). MGFA V, early-onset without depending on E-L-T classification, or difficulty of reduction for high doses of prednisolone can be the target of novel treatment for MG, and future prospective study will be expected.