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Abstract：
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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).
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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).
UNASSIGNED: 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.
摘要：
■本研究旨在阐明早期应用糖皮质激素（GC）对在临床早期治疗重症肌无力（MG）中达到最小表现（MM）状态或更好的影响。
■回顾性分析2015年1月至2022年9月在郑州大学河南医学药物科学研究所（ZMB）接受GC治疗的336例MG患者的数据。患者分为两组：早期单GC组（在MG发作后6个月内接受GC治疗）和延迟单GC组。
■Kaplan-Meier分析表明，早期单GC组比延迟单GC组更早，更频繁地达到MM状态（对数秩检验，p=0.0082；危险比[HR]，1.66；p=0.011）。早期单GC组的维持口服GC剂量低于延迟单GC组。在多元Cox回归分析中，早期单GC(HR，1.50；p=0.043），早发性MG（EOMG）（HR，1.74；p=0.034），和眼MG（OMG）（HR，1.90；p=0.007）与MM状态或更好相关。总之,早期的单GC，EOMG,和OMG是治疗目标的阳性预测因子。在EOMG,OMG,和乙酰胆碱受体抗体阳性MG（AChR-MG）亚组，早期单GC组的维持口服GC剂量显着低于延迟单GC组（p<0.05）。
■早期GC干预导致更好的长期结果，并减少MG患者口服GC的必要维持剂量。EOMG和OMG是MM状态的阳性预测因子或更好的单GC。
■回顾性分析2015年1月至2022年9月在郑州大学河南医学药物科学研究所（ZMB）接受GC治疗的336例MG患者的数据。患者分为两组：早期单GC组（在MG发作后6个月内接受GC治疗）和延迟单GC组。
■Kaplan-Meier分析表明，早期单GC组比延迟单GC组更早，更频繁地达到MM状态（对数秩检验，p=0.0082；危险比[HR]，1.66；p=0.011）。早期单GC组的维持口服GC剂量低于延迟单GC组。在多元Cox回归分析中，早期单GC(HR，1.50；p=0.043），早发性MG（EOMG）（HR，1.74；p=0.034），和眼MG（OMG）（HR，1.90；p=0.007）与MM状态或更好相关。总之,早期的单GC，EOMG,和OMG是治疗目标的阳性预测因子。在EOMG,OMG,和乙酰胆碱受体抗体阳性MG（AChR-MG）亚组，早期单GC组的维持口服GC剂量显着低于延迟单GC组（p<0.05）。
■早期GC干预导致更好的长期结果，并减少MG患者口服GC的必要维持剂量。EOMG和OMG是MM状态的阳性预测因子或更好的单GC。
