CLINICAL TRIAL: THYMECTOMY TO NO THYMECTOMY IN NON -THYMOMATOUS MG PATIENTS

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Myasthenia gravis (MG) is an autoimmune disease in which 85% of patients have antibodies to muscle acetylcholine receptors (AchR-Ab) that interfere with neuromuscular transmission. MG frequently causes severe disability that can be life-threatening. Thymectomy has been established therapy in non-thymomatous MG since 1940, based on retrospective, non-randomized studies. Corticosteroids are now being used increasingly either as the sole treatment or in conjunction with thymectomy. Both therapies have associated adverse effects, and indications for their use based on randomized trial data are lacking. There is therefore an important clinical need to establish the place of thymectomy in the management of MG patients receiving prednisone, specifically extended transsternal thymectomy [ETTX] because it provides an extensive thymic resection with low morbidity and limited risk of nerve injury.