Long-Term Safety and Efficacy of Tacrolimus in Myasthenia Gravis
Long-Term Safety and Efficacy of Tacrolimus in Myasthenia Gravis
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DOI：
10.3349/ymj.2019.60.7.633
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发表时间：
2019-07-01
影响因子：
2.4
通讯作者：
Kim, Seung Min
中科院分区：
文献类型：
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作者：
Kim, Yool-hee;Shin, Ha Young;Kim, Seung Min
目的：重症肌无力（MG）是一种影响神经肌肉传递的终身自身免疫性疾病。长期治疗计划应包括免疫治疗。我们调查了他克莫司治疗MG的长期安全性和有效性在现实世界的临床practice.Materials和方法：我们回顾性分析了160 MG患者与他克莫司治疗2005年至2015年。结果：68例（42.5%）患者发生不良事件，其中大部分为轻微不良事件，且处理良好。与基线相比，他克莫司给药后临床严重程度量表改善。与他克莫司给药前6个月相比，泼尼松龙剂量在治疗后12个月显著降低（2.85 ± 0.92 mg/天，p=0.002），治疗后18个月（3.36 ± 0.99mg/d，p=0.001），治疗后24个月（3.71 ± 0.93mg/d，p < 0.001）。结论：他克莫司可有效降低MG的严重程度，并可减少患者的类固醇剂量。他克莫司治疗引起的不良事件不严重。
Purpose: Myasthenia gravis (MG) is a lifelong autoimmune disorder that affects neuromuscular transmission. The long-term treatment plan should include immunotherapy. We investigated the long-term safety and efficacy of tacrolimus for the treatment of MG in real-world clinical practice.Materials and Methods: We retrospectively reviewed 160 MG patients treated with tacrolimus from 2005 to 2015. Myasthenia Gravis Foundation of America (MGFA) clinical classification, MGFA post-intervention status, myasthenic functional score, and dose of oral prednisolone were investigated.Results: Adverse events occurred in 68 patients (42.5%), most of which were minor and well-managed. Clinical severity scales improved after administration of tacrolimus, compared to the baseline. Compared to 6 months before administration of tacrolimus, prednisolone dose significantly decreased at 12 months after treatment (2.85 +/- 0.92 mg/day, p=0.002), 18 months after treatment (3.36 +/- 0.99 mg/day, p=0.001), and 24 months after treatment (3.71 +/- 0.93 mg/day, p < 0.001).Conclusion: Tacrolimus may be effective in reducing the severity of MG and may permit a reduction in the steroid dose prescribed to the patients. Adverse events due to tacrolimus treatment were not serious.