Argenx, 32 Arch Street, Boston, MA, USA.
Evidera, 500 Totten Pond Road, Waltham, MA, USA.
J Neurol Sci. 2022 Jun 15;437:120268. doi: 10.1016/j.jns.2022.120268. Epub 2022 Apr 21.
BACKGROUND/OBJECTIVES: While the clinical manifestations of myasthenia gravis (MG) are well understood, its humanistic impact is not. The objective of this systematic literature review (SLR) was to provide a comprehensive understanding of the humanistic burden of MG with regards to psychological symptoms and health-related quality of life (HRQoL) according to patients and caregivers.
A systematic search was conducted on December 27, 2019, in MEDLINE and Embase to identify English-language studies that were published from January 1, 2009-December 27, 2019 and presented relevant information on the humanistic burden among adults with MG and their caregivers. Title/abstract and full-text screening was performed by two investigators, with any discrepancies resolved by a third investigator.
Sixty-seven publications were included in the SLR. Compared with the general population, patients with MG experienced worse HRQoL. Studies reporting on psychological symptoms of MG, including depression, anxiety, fatigue, and sleep, were heterogeneous in terms of the scales and instruments used to assess patients, as well as the patient populations themselves. However, in general those with more severe symptoms and hospitalization days had worse depression and anxiety, and fatigue and sleep improved with disease remission and/or improvement. Scores were worse for females compared with males and where evaluated, HRQoL scores generally improved following treatment.
While the literature demonstrates that symptoms associated with MG get better with disease improvement and remission, additional options in efficacious therapy that adequately address the disease-related symptoms and also improve HRQoL may contribute to beneficial outcomes in a greater number of patients with MG.
背景/目的：尽管重症肌无力 (MG) 的临床表现已得到充分了解，但它对人类的影响却尚未可知。本系统文献回顾 (SLR) 的目的是根据患者和护理人员的情况，全面了解 MG 在心理症状和健康相关生活质量 (HRQoL) 方面的人文负担。
2019 年 12 月 27 日，我们对 MEDLINE 和 Embase 进行了系统检索，以确定 2009 年 1 月 1 日至 2019 年 12 月 27 日期间发表的、并提供有关成人 MG 患者及其护理人员人文负担相关信息的英文文献。两名研究人员对标题/摘要和全文进行筛选，如果存在分歧，则由第三名研究人员解决。
本 SLR 共纳入 67 篇文献。与一般人群相比，MG 患者的 HRQoL 更差。报告 MG 心理症状（包括抑郁、焦虑、疲劳和睡眠）的研究在用于评估患者的量表和工具以及患者人群本身方面存在差异。但是，一般来说，症状更严重和住院天数更多的患者抑郁和焦虑更严重，而疾病缓解和/或改善可使疲劳和睡眠得到改善。与男性相比，女性的评分更差，并且在评估的情况下，治疗后 HRQoL 评分通常会改善。
尽管文献表明，与 MG 相关的症状随着疾病的改善和缓解而改善，但更有效的治疗方法中还需要有更多能够充分解决疾病相关症状并改善 HRQoL 的选择，这可能会使更多 MG 患者获得更好的治疗效果。
