KMID : 0311120190600070633
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Yonsei Medical Journal 2019 Volume.60 No. 7 p.633 ~ p.639
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Long-Term Safety and Efficacy of Tacrolimus in Myasthenia Gravis
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Kim Yool-Hee
Shin Ha-Young Kim Seung-Min
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Abstract
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Purpose: Myasthenia gravis (MG) is a lifelong autoimmune disorder that affects neuromuscular transmission. The long-term treatment plan should include immunotherapy. We investigated the long-term safety and efficacy of tacrolimus for the treatment of MG in real-world clinical practice.
Materials and Methods: We retrospectively reviewed 160 MG patients treated with tacrolimus from 2005 to 2015. Myasthenia Gravis Foundation of America (MGFA) clinical classification, MGFA post-intervention status, myasthenic functional score, and dose of oral prednisolone were investigated.
Results: Adverse events occurred in 68 patients (42.5%), most of which were minor and well-managed. Clinical severity scales improved after administration of tacrolimus, compared to the baseline. Compared to 6 months before administration of tacrolimus, prednisolone dose significantly decreased at 12 months after treatment (2.85¡¾0.92 mg/day, p=0.002), 18 months after treatment (3.36¡¾0.99 mg/day, p=0.001), and 24 months after treatment (3.71¡¾0.93 mg/day, p<0.001).
Conclusion: Tacrolimus may be effective in reducing the severity of MG and may permit a reduction in the steroid dose prescribed to the patients. Adverse events due to tacrolimus treatment were not serious.
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KEYWORD
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Myasthenia gravis, tacrolimus, steroid
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