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重症肌无力的疾病负担及其对生活满意度的影响:日本患者观点的定性调查

Myasthenia Gravis Disease Burden and Its Impact on Satisfaction with Life: A Qualitative Survey of Patients' Perspectives in Japan.

作者信息

Kawaguchi Naoki, Tsuda Koichi, Tanaka Nozomu, Kerstens Rene, Harada Daisuke

机构信息

Neurological Center, Neurology Chiba Clinic, Chiba, Japan.

argenx Japan K.K., HULIC JP Akasaka Building, 2-5-8 Akasaka, Minato-ku, Tokyo, 107-0052, Japan.

出版信息

Neurol Ther. 2024 Aug;13(4):1099-1113. doi: 10.1007/s40120-024-00617-6. Epub 2024 May 15.

Abstract

INTRODUCTION

Myasthenia gravis (MG) has a negative impact on patients' health-related quality of life; however, many clinicians do not fully understand their patients' lived experience of the disease. To understand the actual conditions of patients with MG and clarify the problems they perceive, we conducted a survey to evaluate the effects of the disease on patients' daily life and work.

METHODS

A questionnaire-based, qualitative, cross-sectional, non-interventional survey was conducted in Japan between April and May 2022 in patients with MG who were receiving regular outpatient treatment. The questionnaire included items regarding the patients' disease characteristics and experience, satisfaction with life, current treatment status, and treatment satisfaction.

RESULTS

In total, 452 patients were included in the survey population (66.6% aged ≥ 60 years; 64.6% with MG disease duration ≥ 10 years; 76.6% acetylcholine receptor [AChR] autoantibody positive). The symptoms of MG had a significant impact on the patients' daily lives, with the most common symptoms being fatigability (74.8%), ptosis (59.7%), diplopia (54.2%), and weakness in the arms and/or legs (50.9%). Patients commonly identified exercise (73.7%), work 68.0%), hobbies (60.4%), travel (60.0%), and socializing with friends (59.7%) as being difficult to perform, with approximately 50% of patients reporting that hospitalization sometimes interfered with their ability to work. In total, 27.2% of patients were dissatisfied with life, with the highest rates of dissatisfaction among patients who were either positive for muscle-specific kinase (MuSK) autoantibodies or seronegative for both AChR and MuSK autoantibodies.

CONCLUSION

In Japanese patients with MG, over 25% are dissatisfied with life, indicating several unmet needs in this population.

摘要

引言

重症肌无力(MG)对患者与健康相关的生活质量有负面影响;然而,许多临床医生并不完全了解患者对该疾病的实际体验。为了解MG患者的实际情况并阐明他们所察觉到的问题,我们开展了一项调查以评估该疾病对患者日常生活和工作的影响。

方法

2022年4月至5月期间,在日本对接受定期门诊治疗的MG患者进行了一项基于问卷的定性横断面非干预性调查。问卷包括有关患者疾病特征和体验、生活满意度、当前治疗状况以及治疗满意度的项目。

结果

调查人群共纳入452例患者(66.6%年龄≥60岁;64.6%MG病程≥10年;76.6%乙酰胆碱受体[AChR]自身抗体阳性)。MG症状对患者日常生活有显著影响,最常见的症状为易疲劳(74.8%)、上睑下垂(59.7%)、复视(54.2%)以及手臂和/或腿部无力(50.9%)。患者普遍认为运动(73.7%)、工作(68.0%)、爱好(60.4%)、旅行(60.0%)以及与朋友社交(59.7%)难以进行,约50%的患者报告住院有时会影响其工作能力。共有27.2%的患者对生活不满意,其中肌肉特异性激酶(MuSK)自身抗体阳性或AChR和MuSK自身抗体均为血清阴性的患者不满意率最高。

结论

在日本MG患者中,超过25%对生活不满意,表明该人群存在一些未满足的需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59a2/11263327/eac7b2048b02/40120_2024_617_Fig1_HTML.jpg

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