PMID- 32129892
OWN - NLM
STAT- MEDLINE
DCOM- 20200729
LR  - 20200729
IS  - 1097-4598 (Electronic)
IS  - 0148-639X (Linking)
VI  - 61
IP  - 6
DP  - 2020 Jun
TI  - Myasthenia gravis patient and physician opinions about immunosuppressant 
      reduction.
PG  - 767-772
LID - 10.1002/mus.26850 [doi]
AB  - INTRODUCTION: To reduce myasthenia gravis (MG) patient risk of immunosuppressant 
      (IS) exposure adverse events (AEs), such as infections and malignancies, and to 
      reduce treatment burden, international guidelines recommend decreasing IS dose in 
      stable MG patients. METHODS: Online surveys were conducted of self-identified MG 
      patients and MG physician experts about the importance of IS dose reduction for 
      MG patients who achieve prolonged periods of disease stability. RESULTS: 
      Eighty-four percent of MG patients (n = 283) and 100% of physicians (n = 45) were 
      concerned about long-term IS-associated AEs. Although both groups favored 
      attempting IS reduction, they raised concerns including MG relapse, 
      hospitalization, and uncertainty about the future. Presented with an estimated 
      12% significant relapse rate with IS dose reduction, 76% of patients would be 
      willing to enroll in a randomized IS dose reduction trial. DISCUSSION: Patients 
      and physicians favor considering IS dose reduction but are also concerned about 
      potential negative sequelae.
CI  - (c) 2020 Wiley Periodicals, Inc.
FAU - Hehir, Michael K
AU  - Hehir MK
AD  - The Robert Larner M.D. College of Medicine, University of Vermont, Burlington, 
      Vermont, USA.
FAU - Punga, Anna Rostedt
AU  - Punga AR
AUID- ORCID: 0000-0002-2178-9413
AD  - Department of Neuroscience Uppsala University, Uppsala, Sweden.
FAU - Ciafaloni, Emma
AU  - Ciafaloni E
AD  - University of Rochester School of Medicine, Rochester, New York, USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20200320
PL  - United States
TA  - Muscle Nerve
JT  - Muscle & nerve
JID - 7803146
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Female
MH  - *Health Knowledge, Attitudes, Practice
MH  - Humans
MH  - Immunosuppressive Agents/*administration & dosage
MH  - Male
MH  - Middle Aged
MH  - Myasthenia Gravis/*drug therapy/*psychology
MH  - Patient Participation/methods/*psychology
MH  - Physician's Role/*psychology
MH  - Surveys and Questionnaires
OTO - NOTNLM
OT  - disease remission
OT  - immunosuppressant medications
OT  - myasthenia gravis
OT  - treatment
EDAT- 2020/03/05 06:00
MHDA- 2020/07/30 06:00
CRDT- 2020/03/05 06:00
PHST- 2019/06/07 00:00 [received]
PHST- 2020/02/25 00:00 [revised]
PHST- 2020/03/01 00:00 [accepted]
PHST- 2020/03/05 06:00 [pubmed]
PHST- 2020/07/30 06:00 [medline]
PHST- 2020/03/05 06:00 [entrez]
AID - 10.1002/mus.26850 [doi]
PST - ppublish
SO  - Muscle Nerve. 2020 Jun;61(6):767-772. doi: 10.1002/mus.26850. Epub 2020 Mar 20.