Development of a thymectomy trial in nonthymomatous myasthenia gravis patients receiving immunosuppressive therapy

Ann N Y Acad Sci. 2003 Sep:998:473-80. doi: 10.1196/annals.1254.061.

Abstract

Thymectomy has been regularly used in the management of nonthymomatous autoimmune myasthenia gravis (MG), but its benefits have not been established in a randomized, controlled trial. The widespread use of thymectomy in MG patients without thymoma is largely based on retrospective, nonrandomized case series that have produced a consensus that the procedure is sometimes beneficial. Still, the benefits and utilization of thymectomy are actively debated among MG experts. In this paper, we describe the development of a multicenter, international trial to determine whether extended transsternal thymectomy reduces corticosteroid requirements for patients with generalized AChR antibody-positive nonthymomatous MG.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Age of Onset
  • Dose-Response Relationship, Drug
  • Humans
  • Immunosuppression Therapy / methods*
  • Immunosuppressive Agents
  • Middle Aged
  • Myasthenia Gravis / blood
  • Myasthenia Gravis / complications
  • Myasthenia Gravis / immunology
  • Myasthenia Gravis / therapy*
  • Patient Selection
  • Prognosis
  • Receptors, Cholinergic / immunology
  • Retrospective Studies
  • Severity of Illness Index
  • Single-Blind Method
  • Thymectomy / methods*
  • Thymoma / blood
  • Thymoma / complications
  • Thymoma / surgery*
  • Thymus Neoplasms / blood
  • Thymus Neoplasms / complications
  • Thymus Neoplasms / surgery*
  • Time Factors
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Immunosuppressive Agents
  • Receptors, Cholinergic