Therapy » Optimization of corticosteroid therapy for myastenia gravis

Optimization of corticosteroid therapy for myastenia gravis

DOI: https://dx.doi.org/10.18565/therapy.2023.5.26-31

Romanova T.V., Poverennova I.E., Persteneva N.P.
1) Samara State Medical University of the Ministry of Healthcare of Russia; 2) Samara State University of Economics of the Ministry of education and science of Russia

Abstract. Corticosteroids are used as first-line immunosuppressants in case of myasthenia gravis. The scheme and duration of this group of drugs, which allows to achieve the maximum effect of therapy, is still the subject of active scientific research.
The aim: to compare the efficacy of alternative steroid hormone regimens in patients with generalized myasthenia gravis by examining the correlation between dosing regimen and achievement of the optimal therapy goal.
Material and methods. We studied 43 patients with generalized form of myasthenia gravis with a severity of 2–4 classes according to the MGFA scale, who were divided into two groups depending on the dosing regimen of oral corticosteroid. The maximum dose of hormones was 0,8–1,0 mg per 1 kg of the patient’s body weight.
Results. The vast majority of patients responded well to therapy, they showed a significant improvement in their condition and a decrease in the need for anticholinesterase therapy, or a complete rejection of it. Comparative analyzes have shown the advantage of a slower dose reduction regimen. The condition of patients in this group 1–3 months after the end of treatment was significantly better in terms of daily functions, quality of life and survival than in the group receiving therapy according to the «short» regimen, and the onset and maintenance of remission after the end of steroid action was noted in 2,5 times more often.
Conclusion. Thus, reasonable and carefully selected standard therapy regimens significantly improve the results of myasthenia gravis therapy and the perspectives for patients.

Keywords: steroid therapy, myasthenia gravis, treatment optimization

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About the Autors

Tatyana V. Romanova, MD, associate professor, professor of the Department of neurology and neurosurgery, Samara State Medical University of the Ministry of Healthcare of Russia. Address: 443099, Samara, 89 Chapaevskaya Str. E-mail: tvrom63@mail.ru. ORCID: https://orcid.org/0000-0003-2851-8672
Irina E. Poverennova, MD, professor, head of the Department of neurology and neurosurgery, Samara State Medical University of the Ministry of Healthcare of Russia. Address: 443099, Samara, 89 Chapaevskaya Str. E-mail: ipover555@mail.ru. ORCID: https://orcid.org/0000-0002-2594-461X.
Natalya P. Persteneva, PhD in Economics, associate professor of the Department of statistics and econometrics, Samara State University of Economics of the Ministry of education and science of Russia. Address: 443090, Samara, 141 Sovetskoy armii Str. E-mail: persteneva_np@mail.ru. ORCID: https://orcid.org/0000-0003-3845-5011

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