PMID- 30575980
OWN - NLM
STAT- MEDLINE
DCOM- 20190705
LR  - 20190705
IS  - 1097-4598 (Electronic)
IS  - 0148-639X (Linking)
VI  - 59
IP  - 4
DP  - 2019 Apr
TI  - Thymectomy may not be associated with clinical improvement in MuSK myasthenia 
      gravis.
PG  - 404-410
LID - 10.1002/mus.26404 [doi]
AB  - INTRODUCTION: A randomized trial demonstrated benefit from thymectomy in 
      nonthymomatous acetylcholine receptor (AChR)-antibody positive myasthenia gravis 
      (MG). Uncontrolled observational and histologic studies suggest thymectomy may 
      not be efficacious in anti-muscle-specific kinase (MuSK)-MG. METHODS: The 
      therapeutic impact of thymectomy was evaluated from data collected for a 
      multicenter, retrospective blinded review of rituximab in MuSK-MG. RESULTS: 
      Baseline characteristics were similar between thymectomy (n = 26) and 
      nonthymectomy (n = 29) groups, including treatment with rituximab (42% vs. 45%). 
      At last visit, 35% of thymectomy subjects reached the primary endpoint, a 
      Myasthenia Gravis Foundation of America (MGFA) post-intervention status (PIS) 
      score of minimal manifestations (MM) or better, compared with 55% of controls (P 
      = 0.17). After controlling for age at onset of MG, rituximab, prednisone, and 
      intravenous immunoglobulin/plasma exchange treatment, thymectomy was not 
      associated with greater likelihood of favorable clinical outcome (odds ratio = 
      0.43, 95% confidence interval 0.12-1.53, P = 0.19). DISCUSSION: Thymectomy was 
      not associated with additional clinical improvement in this multicenter cohort of 
      MuSK-MG patients. Muscle Nerve 59:404-410, 2019.
CI  - (c) 2019 Wiley Periodicals, Inc.
FAU - Clifford, Katherine M
AU  - Clifford KM
AUID- ORCID: 0000-0001-6969-4846
AD  - Larner College of Medicine, University of Vermont, 1 South Prospect Street, 
      Burlington, Vermont 05401, USA.
FAU - Hobson-Webb, Lisa D
AU  - Hobson-Webb LD
AD  - Department of Neurology, Duke University School of Medicine, Durham, North 
      Carolina, USA.
FAU - Benatar, Michael
AU  - Benatar M
AD  - Department of Neurology, University of Miami Health System, Miami, Florida, USA.
FAU - Burns, Ted M
AU  - Burns TM
AD  - Department of Neurology, University of Virginia School of Medicine, 
      Charlottesville, Virginia, USA.
FAU - Barnett, Carolina
AU  - Barnett C
AUID- ORCID: 0000-0001-5546-0221
AD  - Department of Neurology, University of Toronto School of Medicine, Toronto, 
      Ontario, Canada.
FAU - Silvestri, Nicholas J
AU  - Silvestri NJ
AD  - Department of Neurology, University at Buffalo Jacobs School of Medicine & 
      Biomedical Sciences, Buffalo, New York, USA.
FAU - Howard, James F Jr
AU  - Howard JF Jr
AUID- ORCID: 0000-0002-7136-8617
AD  - Department of Neurology, University of North Carolina School of Medicine, Chapel 
      Hill, North Carolina, USA.
FAU - Visser, Amy
AU  - Visser A
AD  - Department of Neurology, Oregon Health & Science University, Portland, Oregon, 
      USA.
FAU - Crum, Brian A
AU  - Crum BA
AD  - Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.
FAU - Nowak, Richard
AU  - Nowak R
AD  - Department of Neurology, Yale School of Medicine, New Haven, Connecticut, USA.
FAU - Beekman, Rachel
AU  - Beekman R
AD  - Department of Neurology, Yale School of Medicine, New Haven, Connecticut, USA.
FAU - Kumar, Aditya
AU  - Kumar A
AD  - Department of Neurology, Yale School of Medicine, New Haven, Connecticut, USA.
FAU - Ruzhansky, Katherine
AU  - Ruzhansky K
AD  - Department of Neurology, Medical University of South Carolina, Charleston, South 
      Carolina, USA.
FAU - Chen, I-Hweii Amy
AU  - Chen IA
AD  - Department of Neurology, Medical University of South Carolina, Charleston, South 
      Carolina, USA.
FAU - Pulley, Michael T
AU  - Pulley MT
AD  - Department of Neurology, University of Florida, Jacksonville, Florida, USA.
FAU - Laboy, Shannon M
AU  - Laboy SM
AD  - Department of Neurology, University of Florida, Jacksonville, Florida, USA.
FAU - Fellman, Melissa A
AU  - Fellman MA
AD  - Department of Neurology, University of Miami Health System, Miami, Florida, USA.
FAU - Howard, Diantha B
AU  - Howard DB
AD  - Larner College of Medicine, University of Vermont, 1 South Prospect Street, 
      Burlington, Vermont 05401, USA.
FAU - Kolb, Noah A
AU  - Kolb NA
AUID- ORCID: 0000-0003-2651-2349
AD  - Larner College of Medicine, University of Vermont, 1 South Prospect Street, 
      Burlington, Vermont 05401, USA.
FAU - Greene, Shane M
AU  - Greene SM
AD  - Larner College of Medicine, University of Vermont, 1 South Prospect Street, 
      Burlington, Vermont 05401, USA.
FAU - Pasnoor, Mamatha
AU  - Pasnoor M
AD  - Department of Neurology, University of Kansas Medical Center, Kansas City, 
      Kansas, USA.
FAU - Dimachkie, Mazen M
AU  - Dimachkie MM
AD  - Department of Neurology, University of Kansas Medical Center, Kansas City, 
      Kansas, USA.
FAU - Barohn, Richard J
AU  - Barohn RJ
AD  - Department of Neurology, University of Kansas Medical Center, Kansas City, 
      Kansas, USA.
FAU - Hehir, Michael K
AU  - Hehir MK
AD  - Larner College of Medicine, University of Vermont, 1 South Prospect Street, 
      Burlington, Vermont 05401, USA.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20190114
PL  - United States
TA  - Muscle Nerve
JT  - Muscle & nerve
JID - 7803146
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (Receptors, Cholinergic)
RN  - 4F4X42SYQ6 (Rituximab)
RN  - EC 2.7.10.1 (MUSK protein, human)
RN  - EC 2.7.10.1 (Receptor Protein-Tyrosine Kinases)
RN  - VB0R961HZT (Prednisone)
SB  - IM
CIN - Muscle Nerve. 2019 Apr;59(4):393-394. PMID: 30701589
MH  - Adolescent
MH  - Adult
MH  - Age of Onset
MH  - Aged
MH  - Child
MH  - Cohort Studies
MH  - Female
MH  - Humans
MH  - Immunoglobulins, Intravenous/therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Myasthenia Gravis/*genetics/*therapy
MH  - Prednisone/therapeutic use
MH  - Receptor Protein-Tyrosine Kinases/*genetics
MH  - Receptors, Cholinergic/*genetics
MH  - Retrospective Studies
MH  - Rituximab/therapeutic use
MH  - *Thymectomy
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - immunosuppressant therapy
OT  - muscle-specific kinase (MuSK) antibodies
OT  - myasthenia gravis
OT  - rituximab
OT  - thymectomy
EDAT- 2018/12/24 06:00
MHDA- 2019/07/06 06:00
CRDT- 2018/12/22 06:00
PHST- 2018/06/09 00:00 [received]
PHST- 2018/11/24 00:00 [revised]
PHST- 2018/12/16 00:00 [accepted]
PHST- 2018/12/24 06:00 [pubmed]
PHST- 2019/07/06 06:00 [medline]
PHST- 2018/12/22 06:00 [entrez]
AID - 10.1002/mus.26404 [doi]
PST - ppublish
SO  - Muscle Nerve. 2019 Apr;59(4):404-410. doi: 10.1002/mus.26404. Epub 2019 Jan 14.