Steroids have an important role
Steroids have an important role
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DOI：
10.1002/mus.1221
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发表时间：
2002-01-01
期刊：
影响因子：
3.4
通讯作者：
Sanders, DB
中科院分区：
文献类型：
--
作者：
Bedlack, RS;Sanders, DB
Except in mild cases and in patients whose only therapy is thymectomy, patients with myasthenia gravis (MG) require immunosuppressant therapy to suppress the destructive activity of acetylcholine receptor antibodies at the neuromuscular junction. 10, 12 Oral medications are sufficient to control this disease in most patients; however, patients with severe MG associated with significant bulbar symptomatology may require plasma exchange (PE) or intravenous immunoglobulin (IVIg) therapy as well as oral immunosuppressant therapy. Therefore, the selection of an oral immunosuppressant medication is an important consideration for clinicians treating patients with MG.Corticosteroids are used as first-line medical therapy for moderate-to-severe MG. Although steroids are efficacious, large doses are often necessary and frequently produce side effects. 10 Other medications have been used to treat MG, but in most instances as secondary treatments. Assuming that corticosteroids should be used first, these latter medications are reserved for steroid treatment failures or as an adjunct to steroids. Consideration of nonsteroid immunosuppressant medications as firstline therapy may be appropriate; studies are necessary to compare their activity to corticosteroids. It is my opinion that nonsteroid immunosuppressant medications can successfully treat most cases of moderate-to-severe MG with fewer adverse effects than with corticosteroids.
