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

该子项目是利用 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得主要资金， 因此可以在其他CRISP条目中表示。列出的机构是 中心，不一定是研究者的机构。 重症肌无力（MG）是一种自身免疫性疾病，其中85%的患者具有针对肌肉乙酰胆碱受体（AchR-Ab）的抗体，所述抗体干扰肌肉乙酰胆碱受体（AchR-Ab）。 神经肌肉传递MG经常导致严重残疾，可能危及生命。根据回顾性、非随机研究，自1940年以来，胸腺切除术已成为非胸腺瘤性MG的既定治疗方法。皮质类固醇现在越来越多地被用作唯一的治疗方法或与胸腺切除术联合使用。这两种疗法都有相关的不良反应，并且缺乏基于随机试验数据的使用适应症。因此，有一个重要的临床需要，以确定胸腺切除术的MG患者接受泼尼松，特别是扩大经胸骨胸腺切除术[ETTX]的管理，因为它提供了一个广泛的胸腺切除率低，神经损伤的风险有限。

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.