Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Muscle Nerve. 2020 Sep;62(3):377-380. doi: 10.1002/mus.26876. Epub 2020 Apr 15.
Late-onset myasthenia gravis (LOMG; onset after 50 years of age) has different therapeutic decisionmaking challenges than MG in younger patients.
This is a retrospective series of seven patients with acetylcholine receptor antibody-positive MG, all treated with rituximab.
The mean age of onset was 66 years. Three patients were nonresponders to previous therapy and six had developed side effects to prednisone. All patients were treated with at least one dose of rituximab. The MG Foundation of America Post-Intervention Status ranged from MM-0 to MM-3 within a mean of 18.5 weeks. All patients were able to reduce or discontinue maintenance medications. No significant adverse events occurred.
This series highlights the safety and efficacy of rituximab in LOMG. The presence of multiple comorbidities and the risks of other immunotherapy in older patients makes rituximab an attractive option. More experience is needed to clarify the use of rituximab for patients in this age group.
迟发性重症肌无力（LOMG；50 岁以后发病）与年轻患者的重症肌无力相比，在治疗决策上存在不同的挑战。
这是一项回顾性系列研究，共纳入 7 例乙酰胆碱受体抗体阳性的 MG 患者，均接受利妥昔单抗治疗。
发病的平均年龄为 66 岁。3 例患者对既往治疗无反应，6 例患者对泼尼松产生副作用。所有患者均至少接受了一次利妥昔单抗治疗。MG 基金会干预后状态评分在 18.5 周内平均从 MM-0 到 MM-3。所有患者均能够减少或停用维持性药物。未发生明显的不良反应事件。
本系列研究强调了利妥昔单抗治疗 LOMG 的安全性和有效性。老年患者常伴有多种合并症，且其他免疫疗法存在风险，这使得利妥昔单抗成为一种有吸引力的选择。需要更多的经验来明确利妥昔单抗在该年龄组患者中的应用。
