Health-related quality-of-life and treatment targets in myasthenia gravis

Muscle Nerve. 2014 Oct;50(4):493-500. doi: 10.1002/mus.24213. Epub 2014 Aug 30.

Abstract

Introduction: The aim of this study was to determine factors affecting health-related quality of life (HRQOL) and to propose appropriate treatment targets for patients with myasthenia gravis (MG).

Methods: We evaluated 640 consecutive patients with MG seen at 11 neurological centers. Two-year follow-up data were obtained for 282 patients. Correlations between detailed clinical factors and the Japanese version of the 15-item MG-specific QOL scale score were analyzed.

Results: In a cross-sectional analysis of 640 MG patients, multivariate regression revealed that disease severity, as evaluated by the MG Composite (P<0.0001), total dose of oral prednisolone during the last year (P=0.002), and Cushingoid appearance index (P=0.0004), showed significant negative effects on HRQOL, but the quantitative MG score and current prednisolone dose did not.

Conclusions: Achieving minimal manifestations (MM) status or better with prednisolone ≤ 5 mg/day was found to exert a major positive impact on HRQOL in both the cross-sectional and 2-year follow-up patient samples and can be recommended as a treatment target.

Keywords: autoimmune diseases; cohort studies; myasthenia; quality of life; treatment.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Female
  • Health Status*
  • Humans
  • Japan
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Myasthenia Gravis / physiopathology*
  • Myasthenia Gravis / psychology*
  • Myasthenia Gravis / therapy
  • Quality of Life / psychology*
  • Self Concept
  • Severity of Illness Index
  • Statistics as Topic