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Thymectomy may not be associated with clinical improvement in MuSK myasthenia gravis.

Publication ,  Journal Article
Clifford, KM; Hobson-Webb, LD; Benatar, M; Burns, TM; Barnett, C; Silvestri, NJ; Howard, JF; Visser, A; Crum, BA; Nowak, R; Beekman, R ...
Published in: Muscle Nerve
April 2019

INTRODUCTION: A randomized trial demonstrated benefit from thymectomy in nonthymomatous acetylcholine receptor (AChR)-antibody positive myasthenia gravis (MG). Uncontrolled observational and histologic studies suggest thymectomy may not be efficacious in anti-muscle-specific kinase (MuSK)-MG. METHODS: The therapeutic impact of thymectomy was evaluated from data collected for a multicenter, retrospective blinded review of rituximab in MuSK-MG. RESULTS: Baseline characteristics were similar between thymectomy (n = 26) and nonthymectomy (n = 29) groups, including treatment with rituximab (42% vs. 45%). At last visit, 35% of thymectomy subjects reached the primary endpoint, a Myasthenia Gravis Foundation of America (MGFA) post-intervention status (PIS) score of minimal manifestations (MM) or better, compared with 55% of controls (P = 0.17). After controlling for age at onset of MG, rituximab, prednisone, and intravenous immunoglobulin/plasma exchange treatment, thymectomy was not associated with greater likelihood of favorable clinical outcome (odds ratio = 0.43, 95% confidence interval 0.12-1.53, P = 0.19). DISCUSSION: Thymectomy was not associated with additional clinical improvement in this multicenter cohort of MuSK-MG patients. Muscle Nerve 59:404-410, 2019.

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Published In

Muscle Nerve

DOI

EISSN

1097-4598

Publication Date

April 2019

Volume

59

Issue

4

Start / End Page

404 / 410

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Thymectomy
  • Rituximab
  • Retrospective Studies
  • Receptors, Cholinergic
  • Receptor Protein-Tyrosine Kinases
  • Prednisone
  • Neurology & Neurosurgery
  • Myasthenia Gravis
 

Citation

APA
Chicago
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Clifford, K. M., Hobson-Webb, L. D., Benatar, M., Burns, T. M., Barnett, C., Silvestri, N. J., … Hehir, M. K. (2019). Thymectomy may not be associated with clinical improvement in MuSK myasthenia gravis. Muscle Nerve, 59(4), 404–410. https://doi.org/10.1002/mus.26404
Clifford, Katherine M., Lisa D. Hobson-Webb, Michael Benatar, Ted M. Burns, Carolina Barnett, Nicholas J. Silvestri, James F. Howard, et al. “Thymectomy may not be associated with clinical improvement in MuSK myasthenia gravis.Muscle Nerve 59, no. 4 (April 2019): 404–10. https://doi.org/10.1002/mus.26404.
Clifford KM, Hobson-Webb LD, Benatar M, Burns TM, Barnett C, Silvestri NJ, et al. Thymectomy may not be associated with clinical improvement in MuSK myasthenia gravis. Muscle Nerve. 2019 Apr;59(4):404–10.
Clifford, Katherine M., et al. “Thymectomy may not be associated with clinical improvement in MuSK myasthenia gravis.Muscle Nerve, vol. 59, no. 4, Apr. 2019, pp. 404–10. Pubmed, doi:10.1002/mus.26404.
Clifford KM, Hobson-Webb LD, Benatar M, Burns TM, Barnett C, Silvestri NJ, Howard JF, Visser A, Crum BA, Nowak R, Beekman R, Kumar A, Ruzhansky K, Chen I-HA, Pulley MT, Laboy SM, Fellman MA, Howard DB, Kolb NA, Greene SM, Pasnoor M, Dimachkie MM, Barohn RJ, Hehir MK. Thymectomy may not be associated with clinical improvement in MuSK myasthenia gravis. Muscle Nerve. 2019 Apr;59(4):404–410.
Journal cover image

Published In

Muscle Nerve

DOI

EISSN

1097-4598

Publication Date

April 2019

Volume

59

Issue

4

Start / End Page

404 / 410

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Thymectomy
  • Rituximab
  • Retrospective Studies
  • Receptors, Cholinergic
  • Receptor Protein-Tyrosine Kinases
  • Prednisone
  • Neurology & Neurosurgery
  • Myasthenia Gravis