Clinical effect of different immunosuppressive treatment regimens in children with ocular myasthenia gravis: a retrospective analysis.
10.7499/j.issn.1008-8830.2305114
- Author:
Rui-Yan WANG
1
;
Hui CHEN
1
;
Zhi-Xin HUANG
1
;
Yong CHEN
1
;
Jian-Min ZHONG
1
Author Information
1. Department of Neurology, Jiangxi Children's Hospital, Nanchang 330038, China.
- Publication Type:Journal Article
- Keywords:
Adverse reaction;
Child;
Clinical effect;
Glucocorticoid;
Immunosuppressant;
Myasthenia gravis;
Ocular type
- MeSH:
Humans;
Child;
Prednisone/adverse effects*;
Tacrolimus/adverse effects*;
Retrospective Studies;
Activities of Daily Living;
Immunosuppressive Agents/adverse effects*;
Myasthenia Gravis/drug therapy*;
Glucocorticoids/therapeutic use*;
Mycophenolic Acid/adverse effects*
- From:
Chinese Journal of Contemporary Pediatrics
2023;25(10):1034-1039
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVES:To investigate the clinical effect of different immunosuppressive treatment regimens in children with ocular myasthenia gravis (OMG).
METHODS:A retrospective analysis was conducted on 130 children with OMG who were treated in the Department of Neurology, Jiangxi Children's Hospital, from February 2018 to February 2023. According to the treatment regimen, they were divided into four groups: glucocorticoid (GC) group (n=29), mycophenolate mofetil (MMF) group (GC+MMF; n=33), methotrexate (MTX) group (GC+MTX; n=30), and tacrolimus (FK506) group (GC+FK506; n=38). Treatment outcomes and adverse reactions were compared among the groups.
RESULTS:After 3 months of treatment, the FK506 group had significantly lower scores of Myasthenia Gravis Quantitative Scale and Myasthenia Gravis-Specific Activities of Daily Living than the other three groups (P<0.05). After 3 months of treatment, the FK506 group had a significantly lower dose of prednisone than the GC group, and after 6 and 9 months of treatment, the MMF, MTX, and FK506 groups had a significantly lower dose of prednisone than the GC group (P<0.05). After 12 months of treatment, the MMF, MTX, and FK506 groups had a significantly lower incidence rate of GC-related adverse reactions than the GC group (P<0.05).
CONCLUSIONS:For children with OMG, the addition of various immunosuppressants can reduce the dosage of GC and adverse reactions. Among them, FK506 shows superior efficacy compared to other immunosuppressants in the early treatment of OMG.
