Ponseti José M, Azem Jamal, Fort José M, Codina Agustín, Montoro J Bruno, Armengol Manuel
Unit of Myasthenia Gravis, Department of Surgery, Hospital General Universitari Vall d'Hebron, Autonomous University of Barcelona, Passeig Vall d'Hebron 119-129, E-08035 Barcelona, Spain.
Clin Neurol Neurosurg. 2005 Apr;107(3):187-90. doi: 10.1016/j.clineuro.2004.07.013.
Thirteen patients with myasthenia gravis, unresponsive to prednisone and cyclosporin after thymectomy, received KF506 (tacrolimus) for 12 months, at starting doses of 0.1 mg/kg per day b.i.d. and then adjusted to achieve plasma concentrations between 7 and 8 ng/mL. The doses of prednisone were progressively reduced and finally discontinued. Anti-acetylcholine antibodies and myasthenia gravis score for disease severity decreased significantly and muscular strength increased by 37%. All patients achieved pharmacological remission, 11 were asymptomatic and two had minimal weakness of eyelid closure. Tacrolimus was well tolerated and appears a suitable approach after unsuccessful treatment with conventional immunosuppressants in patients with disabling myasthenia.
13例重症肌无力患者在胸腺切除术后对泼尼松和环孢素无反应，接受他克莫司（KF506）治疗12个月，起始剂量为每日0.1mg/kg，分两次服用，然后进行调整以达到血浆浓度在7至8ng/mL之间。泼尼松的剂量逐渐减少，最终停用。抗乙酰胆碱抗体和重症肌无力疾病严重程度评分显著降低，肌肉力量增加了37%。所有患者均实现了药理学缓解，11例无症状，2例仅有轻微的眼睑闭合无力。他克莫司耐受性良好，对于重症肌无力致残患者，在传统免疫抑制剂治疗失败后，似乎是一种合适的治疗方法。
