Myasthenia Gravis

By SWA

 Effectiveness of early glucocorticoids in myasthenia gravis: a retrospective cohort study

Front. Neurol., 19 December 2023

Sec. Neuromuscular Disorders and Peripheral Neuropathies

Purpose: This study aimed to clarify the effect of early glucocorticoid* (GC) application on achieving minimal manifestation (MM) status or better in the treatment of myasthenia gravis (MG) in the early clinical phase.

Methods: A retrospective analysis was performed using data from 336 patients with MG who received GC therapy from January 2015 to September 2022 in the Zhengzhou University Henan Institute of Medical and Pharmaceutical Sciences Myasthenia Gravis Biobank (ZMB). Patients were divided into two groups: the early mono-GC group (treated with GC within 6 months of MG onset) and the delayed mono-GC group.

Results: Kaplan–Meier analysis showed that the early mono-GC group achieved MM status earlier and more frequently than the delayed mono-GC group (log-rank test, p = 0.0082; hazard ratio [HR], 1.66; p = 0.011). The early mono-GC group had a lower maintenance oral GC dose than the delayed mono-GC group. In multivariate Cox regression analysis, early mono-GC (HR, 1.50; p = 0.043), early-onset MG (EOMG) (HR, 1.74; p = 0.034), and ocular MG (OMG) (HR, 1.90; p = 0.007) were associated with MM status or better. In conclusion, early mono-GC, EOMG, and OMG were positive predictors of treatment goals. In EOMG, OMG, and acetylcholine receptor antibody-positive MG (AChR-MG) subgroups, the maintenance oral GC doses in the early mono-GC group were significantly lower than the doses in the delayed mono-GC group (p < 0.05).

Conclusion: Early intervention with GC led to better long-term outcomes and reduced the necessary maintenance dose of oral GC for patients with MG. EOMG and OMG were positive predictors of MM status or better with mono-GC.

https://www.frontiersin.org/articles/10.3389/fneur.2023.1259484/full?utm_source=S-TWT&utm_medium=SNET&utm_campaign=ECO_FNEUR_XXXXXXXX_auto-dlvrit

 

Details:

* Glucocorticoids are steroid hormones produced from the cortex of adrenal glands (gluco-corti-coids: glucose-cortex-steroids). Glucocorticoids have a pivotal role in the glucose, protein, and fat metabolism of the body.

What is the function of glucocorticoid hormone?

Glucocorticoid hormones regulate essential body functions in mammals, control cell metabolism, growth, differentiation, and apoptosis.

What do glucocorticoids do in the body?

Glucocorticoids are cholesterol-derived steroid hormones synthesized and secreted by the adrenal gland. They are anti-inflammatory in all tissues, and control metabolism in muscle, fat, liver and bone. Glucocorticoids also affect vascular tone, and in the brain influence mood, behavior and sleep‒wakefulness cycles.

What is glucocorticoid vs cortisol?

Cortisol is a glucocorticoid hormone that your adrenal glands produce and release. Hormones are chemicals that coordinate different functions in your body by carrying messages through your blood to your organs, skin, muscles and other tissues.

What disease is caused by glucocorticoid?

Exogenous Cushing syndrome occurs when a person takes man-made (synthetic) glucocorticoid medicines to treat a disease. These medicines act like cortisol in the body.

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