UOC Neurologia, Salute Pubblica, Disabilità, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy,
Dipartimento di Ricerca e Sviluppo Clinico, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy.
Neuroepidemiology. 2020;54(4):304-312. doi: 10.1159/000506310. Epub 2020 Feb 25.
Myasthenia gravis (MG) is an autoimmune disease whose period of typical onset is around 20-40 years (i.e., early onset), thus in the peak of working age, or around 60-80 years (i.e., late onset). However, the information on work-related issues and employment status are sparse and not systematically reported. Therefore, we performed a systematic literature review with meta-analysis to address the employment status of MG patients.
We searched for papers reporting employment status on participants with MG published between January 2000 and May 2019. Information on employment was extracted. Random-effects models were used to produce meta-analytic estimates for the proportion of employed patients.
In total, 1,045 records were retrieved, of which 19 fitted the inclusion criteria. In total, 3,600 participants (average age 47.5, range 35-60) were included in the studies and 1,579 of them were employed. The proportion of employed patients varied from 28 to 82%, with an extreme heterogeneity between studies. Overall, the pooled proportion of workers was 50% (95% CI 41-60%). Subgroup analyses suggested a possible, although not significant, higher proportion of workers among women, younger participants, those with a higher level of education, shorter MG duration, and less frequently thymectomized, whereas a lower proportion was observed among those with generalized, bulbar, and respiratory symptoms.
The results of our meta-analysis show that the percentage of employment is considerably low if we take into account that the mean age of MG patients involved in the included studies was around 48 years, thus in peak of working life. Therefore, it is important to understand what kind of influence MG exerts on work dynamics.
重症肌无力（MG）是一种自身免疫性疾病，其典型发病期在 20-40 岁左右（即早发），因此正值工作年龄高峰期，或在 60-80 岁左右（即晚发）。然而，有关工作相关问题和就业状况的信息很少，且没有系统报告。因此，我们进行了系统的文献综述和荟萃分析，以解决 MG 患者的就业状况。
我们检索了 2000 年 1 月至 2019 年 5 月间发表的有关 MG 患者就业状况的论文。提取有关就业的信息。使用随机效应模型生成就业患者比例的荟萃分析估计值。
共检索到 1045 条记录，其中 19 条符合纳入标准。共有 3600 名参与者（平均年龄 47.5 岁，范围 35-60 岁）纳入研究，其中 1579 人就业。就业患者的比例从 28%到 82%不等，研究之间存在明显的异质性。总体而言，工人的总体比例为 50%（95%CI 41-60%）。亚组分析表明，女性、年轻参与者、教育程度较高、MG 病程较短、胸腺切除较少的患者中，工人的比例可能较高，但在全身性、延髓性和呼吸性症状患者中，工人的比例较低。
我们的荟萃分析结果表明，如果考虑到纳入研究的 MG 患者的平均年龄约为 48 岁，即处于工作高峰期，那么就业的百分比相当低。因此，了解 MG 对工作动态的影响非常重要。
