Changes in quality of life scores with intravenous immunoglobulin or plasmapheresis in patients with myasthenia gravis
Changes in quality of life scores with intravenous immunoglobulin or plasmapheresis in patients with myasthenia gravis
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DOI：
10.1136/jnnp-2011-301449
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发表时间：
2013-01-01
影响因子：
11
通讯作者：
Bril, Vera
中科院分区：
文献类型：
--
作者：
Barnett, Carolina;Wilson, Graham;Bril, Vera
背景静脉注射免疫球蛋白（IVIG）和血浆置换目的探讨免疫调节治疗对重症肌无力（MG）患者生活质量（QOL）的改善作用是否与静脉丙种球蛋白（IVIG）或血浆置换（PLEX）相当。60研究，在基线和治疗后第14天完成问卷。根据MG-QOL-60问卷回答计算MG-QOL-15评分。结果IVIG组和PLEX组在第14天的生活质量量表评分均下降，但组间差异无统计学意义（QOL-15：IVIG-5.7 +/- 8.5，PLEX：-7.0 +/- 7.6，p=0.52; QOL-60：IVIG-13.3 +/- 16.9，PLEX-18.5 +/- 22.0，p=0.41）。QOL的改善与QMGS的降低具有良好的相关性。MG-QOL-15和MG-QOL-60在基线和第14天的评分之间具有良好的相关性。结论本研究MG-QOL变化支持最近的研究结果，即IVIG和PLEX在治疗中重度MG和症状恶化的患者方面具有可比性。此外，我们的研究支持在未来的MG临床试验中使用MG-QOL-15作为次要结局指标。
Background Intravenous immunoglobulin (IVIG) and plasmapheresis (plasma exchange (PLEX)) have comparable efficacy in reducing the Quantitative Myasthenia Gravis Score for disease severity (QMGS) in patients with moderate to severe myasthenia gravis (MG).Objective To determine if the improvement in the quality of life (QOL) after immunomodulation is comparable with either IVIG or PLEX.Methods 62 patients participated in the MG-QOL-60 study, completing the questionnaire at baseline and at day 14 after treatment. The MG-QOL-15 scores were computed from the MG-QOL-60 questionnaire responses. We analysed the change in the QOL scores from baseline to day 14 in both treatment groups.Results The scores in both QOL scales decreased at day 14 in the IVIG and PLEX groups, without significant difference between groups (QOL-15: IVIG -5.7 +/- 8.5, PLEX: -7.0 +/- 7.6, p=0.52; QOL-60: IVIG -13.3 +/- 16.9, PLEX -18.5 +/- 22.0, p=0.41). The improvement in QOL showed a good correlation with the decrease in QMGS. There was an excellent correlation between the MG-QOL-15 and MG-QOL-60 scores at baseline and at day 14.Conclusions This study of MG-QOL changes supports recent findings that IVIG and PLEX are comparable in the treatment of patients with moderate to severe MG and worsening symptoms. Furthermore, our study supports the use of the MG-QOL-15 as a secondary outcome measure in future clinical trials in MG.