Department of Neurology, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium.
Department of Thoracic and Vascular Surgery, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium.
Acta Neurol Belg. 2023 Apr;123(2):375-384. doi: 10.1007/s13760-023-02187-0. Epub 2023 Jan 20.
As new treatments are becoming available for patients with myasthenia gravis (MG), it is worth reflecting on the actual status of MG treatment to determine which patients would most likely benefit from the new treatments.
We reviewed the clinical files of all MG patients seen at the Department of Neurology of the Antwerp University Hospital during the years 2019, 2020 and 2021.
163 patients were included. Age at diagnosis varied from the first to the eighth decades, with a peak of incidence from 60 to 70 years for both genders, and an additional peak from 20 to 30 years in women. Diplopia and ptosis were by far the most common onset symptom. At maximum disease severity, 24% of the patients still had purely ocular symptoms and 4% needed mechanical ventilation. 97% of the patients received a treatment with pyridostigmine and 68% with corticosteroids, often in combination with immunosuppressants. More than half reported side effects. At the latest visit, 50% of the patients were symptom-free. Also, half of the symptomatic patients were fulltime at work or retired with no or mild limitations in daily living. The remaining patients were working part-time, on sick leave, or retired with severe limitations.
The majority of MG patients are doing well with currently available treatments, but often at the cost of side effects in the short and in the long term. A significant group is in need of better treatments.
随着新的治疗方法在重症肌无力（MG）患者中得到应用，值得反思 MG 的实际治疗现状，以确定哪些患者最有可能从新的治疗方法中获益。
我们回顾了 2019 年、2020 年和 2021 年期间在安特卫普大学医院神经内科就诊的所有 MG 患者的临床档案。
共纳入 163 例患者。诊断时年龄从第一个十年到第八个十年不等，两性发病率高峰均为 60 至 70 岁，女性额外高峰为 20 至 30 岁。复视和上睑下垂是迄今为止最常见的起始症状。在疾病最严重时，仍有 24%的患者仅有眼肌症状，4%的患者需要机械通气。97%的患者接受了吡啶斯的明治疗，68%的患者接受了皮质类固醇治疗，通常与免疫抑制剂联合使用。超过一半的患者报告有副作用。在最近一次就诊时，50%的患者无症状。此外，一半的有症状患者全职工作或退休，日常生活无或仅有轻微受限。其余患者兼职工作、休病假或退休，生活严重受限。
大多数 MG 患者使用现有治疗方法效果良好，但通常会带来短期和长期的副作用。有相当一部分患者需要更好的治疗方法。
