Thymectomy Improves Outcomes in Myasthenia Gravis

Study compared thymectomy plus alternate-day prednisone with alternate-day prednisone alone

THURSDAY, Aug. 11, 2016 (HealthDay News) -- Thymectomy improves clinical outcomes over a three-year period in patients with nonthymomatous myasthenia gravis, according to research published in the Aug. 11 issue of the New England Journal of Medicine.

The study ran from 2006 until 2012 and included 126 patients with generalized nonthymomatous myasthenia gravis who participated at one of 36 centers on six continents. The patients were randomly placed into one of two treatment groups. About half received a thymectomy plus alternate-day prednisone. The rest of the study volunteers received alternate-day prednisone alone.

The researchers reported that patients treated with thymectomy had lower time-weighted average Quantitative Myasthenia Gravis score over three years than patients treated with prednisone alone. They also required about less prednisone and less immunosuppression with azathioprine, and fewer patients required hospitalization for exacerbations, compared with patients who didn't receive the surgery.

"In conclusion, this randomized, medication-controlled, rater-blinded trial showed a benefit of thymectomy in patients with myasthenia gravis over a period of three years with respect to clinical outcomes, requirements for prednisone and azathioprine therapy, the number of symptoms and the distress level related to immunosuppressive agents, and the need for hospitalization to manage disease exacerbations," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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