Intravenous methylprednisolone therapy for ocular myasthenia gravis: A retrospective study

Author:

Yorozu Shoko1ORCID,Koh Jinsoo1,Miyamoto Katsuichi1,Sakata Mayumi1,Nakayama Yoshiaki1ORCID,Takahashi Maiko1,Mori Megumi1,Taruya Junko1,Matsumoto Takuya1,Minamino Mai1,Ogami Shuhei1,Niwa Mayako1,Hiwatani Yasuhiro12,Kajimoto Yoshinori13,Ishiguchi Hiroshi14,Ito Hidefumi1

Affiliation:

1. Department of Neurology Wakayama Medical University Wakayama Japan

2. Department of Neurology Wakayama Rosai Hospital Wakayama Japan

3. Department of Internal Medicine Wakayama Medical University Kihoku Hospital Wakayama Japan

4. Department of Neurology Shingu Municipal Medical Center Wakayama Japan

Abstract

AbstractBackgroundAlthough intravenous methylprednisolone pulse (IVMP) therapy has been recommended for ocular myasthenia gravis (OMG), the evidence is limited.AimWe aimed to investigate the efficacy and safety of IVMP for OMG.MethodsThe patients with OMG were chosen retrospectively from May 2010 to December 2022. The therapeutic effects between IVMP‐treated and non‐IVMP‐treated groups were determined by ∆ocular quantitative MG (QMG) score and the ∆ocular MG activities of daily living profile (MG‐ADL) score, which is the disparities of the scores between before and after 1 month of drug administration; and Myasthenia Gravis Foundation of America post‐intervention status at 1, 3, 6, and 12 months.ResultsThere were 26 patients with OMG included, with the mean age of 67.2 ± 13.1 years. 13 of the 26 people with OMG received IVMP and subsequent low‐dose immunotherapies. The ∆ocular QMG and ∆ocular MG‐ADL scores were significantly higher in the IVMP group of 3 (1.5, 4) and 3 (2, 4.5) than in the non‐IVMP group of 1.5 (0, 3) and 1 (0, 2), p = 0.038 and p = 0.0027, respectively. The rates of minimal manifestation or better status in post‐intervention status at 1 and 12 months were also considerably higher in the IVMP group of 77% and 92% compared with the non‐IVMP group of 0% and 23%, p = 0.0001 and 0.001. There were no serious side effects discovered.ConclusionIVMP induction therapy can quickly and safely improve symptoms of OMG, and subsequent low‐dose immunotherapy can keep symptoms at bay for 12 months.

Publisher

Wiley

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