Possible sex and racial disparities in myasthenia gravis care DOI Creative Commons

Shriya Suresh,

Maya Watanabe, Evan L. Reynolds

et al.

Muscle & Nerve, Journal Year: 2024, Volume and Issue: unknown

Published: July 29, 2024

Abstract Introduction/Aims Given the importance of early diagnosis and treatment myasthenia gravis (MG), it is critical to understand disparities in MG care. We aimed determine if there are any differences testing, treatment, and/or access neurologists for patients varying sex race/ethnicity with MG. Methods used a nationally representative healthcare claims database privately insured individuals (2001–2018) identify incident cases using validated definition. Diagnostic steroid‐sparing agents, intravenous immunoglobulin (IVIG), plasma exchange (PLEX), thymectomy were defined drug names or CPT codes. Steroid use was AHFS class also determined whether an individual had visit neurologist time between primary care visits. Logistic regression associations treatments, neurologists. Results Female less likely get computed tomography (CT) chest (odds ratio (OR) 0.73, 95% confidence interval (CI): 0.64–0.83), receive steroids (OR: 0.85, CI: 0.75–0.97), agents 0.84, 0.72–0.97), IVIG PLEX 0.80, 0.67–0.95). Black 0.78, 0.63–0.96). No significant seen Discussion found female receiving than men those other races/ethnicities. Further research detailed assessments accounting patient factors needed confirm these apparent disparities.

Language: Английский

Fatigue, physical activity and associated factors in 779 patients with myasthenia gravis DOI Creative Commons
Linda Kahr Andersen, Mette Aadahl, John Vissing

et al.

Neuromuscular Disorders, Journal Year: 2021, Volume and Issue: 31(8), P. 716 - 725

Published: May 27, 2021

The objective of the study was to examine association between fatigue (measured by Multidimensional Fatigue Inventory; MFI-20) and physical activity Saltin-Grimby Physical Activity Level Scale; SGPALS) in a large cohort patients (≥18 years) with myasthenia gravis (MG) including relevant disease - lifestyle-related factors. A total 1463 persons, registered at Danish National Registry Patients MG diagnosis, according International Classification Diseases, received web-based survey. 779 (53% women, mean [SD] age 60.8 [15.5]) responded. remaining persons were either non-responders (n = 390) or could not confirm diagnosis 294). most prominent MFI-20 domains general (median [inter-quartile ranges, IQR], 13 [10-16]) [IQR], [9-15]), 386 (53%) reported low levels activity. All associated (p<.01). Higher level lower fatigue. Important factors for severity Myasthenia Gravis Activities Daily Living profile), body mass index, insomnia Insomnia Severity Index) job-status, comorbidity, cohabitation.

Language: Английский

Citations

23
Depression in myasthenia gravis: a heterogeneous and intriguing entity DOI
Yury V. Gavrilov,

Tatjana M. Alekseeva,

O. A. Kreis

et al.

Journal of Neurology, Journal Year: 2020, Volume and Issue: 267(6), P. 1802 - 1811

Published: March 5, 2020

Language: Английский

Citations

21
One‐year follow‐up of disease burden and medication changes in patients with myasthenia gravis: From the MG Patient Registry DOI
Ikjae Lee, Justin M. Leach, Inmaculada Aban

et al.

Muscle & Nerve, Journal Year: 2022, Volume and Issue: 66(4), P. 411 - 420

Published: June 8, 2022

We studied the progression of myasthenia gravis (MG) disease burden and medication adjustment among MG Patient Registry participants.Participants diagnosed with (age ≥18 years), registered between July 1, 2013 31, 2018 completing both 6- 12-month follow-up surveys, were included in this investigation. Participants grouped into high-burden (Myasthenia Gravis Activity Daily Living scale [MG-ADL] score ≥6) low-burden (MG-ADL <6) groups based on MG-ADL scores at enrollment. Demographics history compared groups. change changes (escalation, no change, de-escalation) enrollment Minimal symptom expression (MSE, <2) 12 months was Logistic regression analysis performed to study factors associated MSE months.In total, 520 participants (56% female) (n = 248) 272) Those group more likely be younger, female, have shorter duration. At months, achieved 6% newly (42 201, 21%) or maintained (52 71, 73%) group. In multivariable analysis, being use pyridostigmine less likelihood MSE, whereas improvement (>2 >20%) 6 significantly increased achieving (P .0004).In groups, but so group, patients infrequently after 1 year treatment. Baseline low burden, a higher months.

Language: Английский

Citations

13
Chronic stress, depression and personality type in patients with myasthenia gravis DOI Open Access
Anca Bogdan, Carolina Barnett, Ahmed Salah Ali

et al.

European Journal of Neurology, Journal Year: 2019, Volume and Issue: 27(1), P. 204 - 209

Published: Aug. 13, 2019

Stress is a known risk factor for the onset and modulation of disease activity in autoimmune disorders. The aim this cross-sectional study was to determine any associations between myasthenia gravis (MG) severity chronic stress, depression personality type.In all, 179 consecutive adult patients with confirmed MG attending Neuromuscular Clinic March 2017 December were included. At baseline, assessed clinically they completed self-administered scales severity, perceived type.Higher [Myasthenia Gravis Impairment Index (MGII)] showed moderate correlation score (Beck's Depression Inventory, Second Edition, r = 0.52, P < 0.001) lower stress (Trier Inventory Assessment Chronic Stress, 0.28, 0.001). scores different according types (anova, 0.02). linear regression model MGII as dependent variable R2 0.34, likelihood ratio chi-squared 74.55, 0.0001. only variables that predicted (P 0.0001) female sex 0.003).A significant association found, well gender. These findings should raise awareness long-term management address potential consider behavioural prevent stress-related immune imbalance.

Language: Английский

Citations

20
Causes of symptom dissatisfaction in patients with generalized myasthenia gravis DOI
Linda Kahr Andersen,

Anna Sofie Jakobsson,

Karoline Lolk Revsbech

et al.

Journal of Neurology, Journal Year: 2021, Volume and Issue: 269(6), P. 3086 - 3093

Published: Nov. 21, 2021

Language: Английский

Citations

17
Exploring Factors That Prolong the Diagnosis of Myasthenia Gravis DOI
Minh Nguyen, Meaghan Clough, Belinda Cruse

et al.

Neurology Clinical Practice, Journal Year: 2024, Volume and Issue: 14(1)

Published: Jan. 4, 2024

Myasthenia gravis (MG) is a condition with significant phenotypic variability, posing diagnostic challenge to many clinicians worldwide. Prolonged diagnosis can lead reduced remission rates and morbidity. This study aimed identify factors leading longer time in MG that could be addressed future optimize time.

Language: Английский

Citations

2
Fatigue and associated factors in myasthenia gravis: a nationwide registry study DOI Creative Commons

Mattea Funke,

Maria Eveslage, Jana Zschüntzsch

et al.

Journal of Neurology, Journal Year: 2024, Volume and Issue: 271(8), P. 5665 - 5670

Published: June 13, 2024

Abstract Fatigue is commonly associated with myasthenia gravis (MG), but factors contributing to fatigue development in MG are incompletely understood. This nationwide cross-sectional registry study included 1464 patients diagnosed autoimmune MG, recruited between February 2019 and April 2023. Frequency severity of was assessed at inclusion using the patient-reported Chalder Questionnaire (CFQ). 59%. strongly correlated both physician-assessed outcome measures (MG-ADL, MG-QoL15, QMG MGFA classes) a history myasthenic exacerbation and/or crises delay diagnosis more than 1 year after symptom onset. prevalent women coincided symptoms depression, anxiety, sleep dissatisfaction. Differences were observed antibody (ab) subgroups, highest LRP4-ab-positive lowest AChR-ab-positive patients. frequent clinically highly relevant MG. Early prevention may limit long-term burden

Language: Английский

Citations

2
Physical and mental fatigue in myasthenia gravis and its correlation with other symptoms DOI
Ayşegül Akkan Suzan, Pınar Kahraman Koytak, Kayıhan Uluç

et al.

Acta Neurologica Belgica, Journal Year: 2022, Volume and Issue: 122(4), P. 915 - 923

Published: March 25, 2022

Language: Английский

Citations

10
Outcomes after thymectomy in non-thymomatous myasthenia gravis DOI Open Access
Nathaniel Deboever, Xu Ying, Hope Feldman

et al.

Journal of Thoracic Disease, Journal Year: 2023, Volume and Issue: 15(6), P. 3048 - 3053

Published: May 9, 2023

Guidelines by the myasthenia gravis (MG) Foundation of America suggest patients aged 18 to 50 years with non-thymomatous (NTMG) benefit from thymectomy. Our objective was investigate utilization thymectomy in NTMG outside confines a clinical trial.From Optum de-identified Clinformatics Data Mart Claims Database (2007 2021), we identified diagnosed MG between 18-50 old. We then selected who received within 12 months diagnosis. Outcomes included use steroids, non-steroidal immunosuppressive agents (NSIS), and rescue therapy (plasmapheresis or intravenous immunoglobulin), as well NTMG-related emergency department (ED) visits hospital admissions. These outcomes were compared 6-months before after thymectomy.A total 1,298 met our inclusion criteria, whom 45 (3.47%) thymectomy, performed via minimally invasive surgery 53.3% cases (n=24). In comparing pre- post-operative period, noted that steroid increased (53.33% 66.67%, P=0.034), NSIS remained stable, decreased (44.44% 24.44%, P=0.007). Costs associated stable. However, mean costs (from $13,243.98 $8,486.26, P=0.035). Hospital admissions ED related There 2 readmissions 90 days (4.44%) thymectomy.Patients undergoing experienced less need for following resection, albeit rates prescriptions. Thymectomy is infrequently this patient population despite acceptable postsurgical outcomes.

Language: Английский

Citations

5
Diversity in mental fatigue and social profile of patients with myasthenia gravis in two different Northern European countries DOI Creative Commons

Liis Sabre,

Elisabet Westerberg,

Maarika Liik

et al.

Brain and Behavior, Journal Year: 2017, Volume and Issue: 7(4)

Published: March 1, 2017

Abstract Self‐estimated health can be used for comparison of different diseases between countries. It is important to elaborate on whether disparities in self‐estimated are due disease‐specific parameters or socioeconomic differences. In this study, we aimed at evaluating clinical and social similarities differences myasthenia gravis ( MG ) patients comparable regions two Baltic Sea countries, Estonia Sweden. Methods This cross‐sectional study included southern counties Sweden size. All with a confirmed diagnosis were asked answer questionnaires including demographic data, lifestyle issues, mental fatigue (Fatigue Severity Scale [ FSS ]). Clinical was assessed objectively through the Quantitative Myasthenia Gravis Score QMG ). Results Thirty‐six 92 identified 40 70 chose participate study. The characteristics symptoms reported by similar. score did not differ; however, Estonian scored their current subjective disease severity significantly higher (5.6 ± 2.8) compared Swedish (3.4 2.3, p = .0005). also had scores (5.0 1.7) than (3.5 1.6; .001). more active performed physical activity regularly (29.1% 74.2% Sweden, .004). Conclusions Although, fatigue, evaluated state as being severe patients. These data indicate large regional perception , which consider international studies.

Language: Английский

Citations

15