| Autor: |
Katherine A, Buzzard, Nicholas J, Meyer, Todd A, Hardy, D Sean, Riminton, Stephen W, Reddel |
| Rok vydání: |
2014 |
| Předmět: |
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| Zdroj: |
Musclenerve. 52(2) |
| ISSN: |
1097-4598 |
| Popis: |
Myasthenia gravis (MG) can be refractory to conventional immunotherapy. We report on the efficacy and durability of intravenous (IV) remission-induction cyclophosphamide (CYC) followed by oral immunosuppression in refractory MG.We identified 8 patients from our medical records with moderate or severe refractory MG who were treated with 6 cycles of IV CYC (0.75 g/m(2) ) every 4 weeks followed by oral immunosuppression.Six patients improved within 3 months of treatment. Four patients remained in clinical remission (mean follow-up 31 months). Two patients responded partially, and 1 patient relapsed after 11 months. Two patients were non-responders. CYC was well tolerated. Acetylcholine receptor antibody levels remained below pretreatment levels in patients in clinical remission. The leukocyte nadir was lower in CYC responders.Remission-induction IV CYC followed by oral immunosuppression is a rapid, effective, and durable treatment for refractory MG. Adding a post-CYC immunosuppressant may account for low relapse rates compared with other published series. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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