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• Vol.62 No.12
• CLINICA NEUROL, 62: 915−921, 2022
• Vol.62 No.12 contents

Original Article

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

Takamichi Sugimoto, M.D., Ph.D.¹⁾²⁾, Takemori Yamawaki, M.D., Ph.D.¹⁾³⁾, Hiroyuki Naito, M.D., Ph.D.¹⁾²⁾, Narumi Ohno, M.D.¹⁾, Mayumi Giga, M.D.¹⁾, Tomoyuki Kono, M.D., Ph.D.¹⁾, Kazuhide Ochi, M.D., Ph.D.⁴⁾, Tatsuo Kohriyama, M.D., Ph.D.⁵⁾, Eiichi Nomura, M.D., Ph.D.¹⁾ and Hirofumi Maruyama, M.D., Ph.D.²⁾

¹⁾ Department of Neurology, Hiroshima City Hiroshima Citizens Hospital
²⁾ Department of Clinical Neuroscience and Therapeutics, Hiroshima University
³⁾ Department of Internal Medicine, Hiroshima Teishin Hospital
⁴⁾ Department of Neurology, Hiroshima Prefectural Hospital
⁵⁾ Department of Neurology, Brain Attack Center, Ota Memorial Hospital

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.
Full Text of this Article in Japanese PDF (551K)

(CLINICA NEUROL, 62: 915−921, 2022)
key words: refractory, fast-acting treatment, postintervention status

(Received: 2-Jul-22)