Subcutaneous Immunoglobulin Therapy in the Chronic Management of Myasthenia Gravis: A Retrospective Cohort Study

Autor: Pierre R. Bourque, C. E. Pringle, Juthaporn Cowan, J. Warman Chardon, William Cameron
Rok vydání: 2016
Předmět:
Male
Pediatrics
Critical Care and Emergency Medicine
Physiology
lcsh:Medicine
Subcutaneous immunoglobulin
Biochemistry
Cohort Studies
0302 clinical medicine
Immune Physiology
Activities of Daily Living
Medicine and Health Sciences
lcsh:Science
Routes of Administration
Aged
80 and over
Immune System Proteins
Multidisciplinary
biology
Drugs
Immunoglobulins
Intravenous
Treatment options
Middle Aged
Immunosuppressives
Hospitalization
Treatment Outcome
Patient Satisfaction
Female
Antibody
Research Article
Adult
medicine.medical_specialty
Patients
Injections
Subcutaneous
Immunology
Antibodies
Autoimmune Diseases
Immune Deficiency
Young Adult
03 medical and health sciences
Patient satisfaction
Intravenous Injections
Myasthenia Gravis
medicine
Humans
Immunologic Factors
Retrospective Studies
Pharmacology
030203 arthritis & rheumatology
business.industry
lcsh:R
Biology and Life Sciences
Proteins
Retrospective cohort study
medicine.disease
Myasthenia gravis
Surgery
Health Care
Chronic Disease
Quality of Life
biology.protein
lcsh:Q
Clinical Immunology
Clinical Medicine
business
030217 neurology & neurosurgery
Follow-Up Studies
Zdroj: PLoS ONE
PLoS ONE, Vol 11, Iss 8, p e0159993 (2016)
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0159993
Popis: Background Immunoglobulin therapy has become a major treatment option in several autoimmune neuromuscular disorders. For patients with Myasthenia Gravis (MG), intravenous immunoglobulin (IVIg) has been used for both crisis and chronic management. Subcutaneous Immunoglobulins (SCIg), which offer the advantage of home administration, may be a practical and effective option in chronic management of MG. We analyzed clinical outcomes and patient satisfaction in nine cases of chronic disabling MG who were either transitioned to, or started de novo on SCIg. Methods and Findings This was a retrospective cohort study for the period of 2015–2016, with a mean follow-up period of 6.8 months after initiation of SCIg. All patients with MG treated with SCIg at the Ottawa Hospital, a large Canadian tertiary hospital with subspecialty expertise in neuromuscular disorders were included, regardless of MG severity, clinical subtype and antibody status. The primary outcome was MG disease activity after SCIg initiation. This outcome was measured by 1) the Myasthenia Gravis Foundation of America (MGFA) clinical classification, and 2) subjective scales of disease activity including the Myasthenia Gravis activities of daily living profile (MG-ADL), Myasthenia Gravis Quality-of-life (MG-QOL 15), Visual Analog (VA) satisfaction scale. We also assessed any requirement for emergency department visits or hospitalizations. Safety outcomes included any SCIg related complication. All patients were stable or improved for MGFA class after SCIg initiation. Statistically significant improvements were documented in the MG-ADL, MG-QOL and VAS scales. There were no exacerbations after switching therapy and no severe SCIg related complications. Conclusions SCIg may be a beneficial therapy in the chronic management of MG, with favorable clinical outcome and patient satisfaction results.
Databáze: OpenAIRE
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