Methotrexate Use in Generalized Autoimmune Myasthenia Gravis: A Case series
DOI:
https://doi.org/10.17161/rrnmf.v2i5.15795Keywords:
myasthenia gravis, methotrexate, immunosuppression, corticosteroid, acetylcholine receptor antibodyAbstract
Methotrexate (MTX) is an inexpensive and well-tolerated immunosuppressive medication that is used anecdotally in autoimmune myasthenia gravis (MG). However, the efficacy in MG is unclear at this time. This retrospective analysis describes six patients with acetylcholine receptor antibody positive MG who were treated with MTX and corticosteroids. The efficacy of MTX was measured by steroid-sparing effect and the Myasthenia Gravis Foundation of America (MGFA) classification. MTX initiation was associated with a reduction in prednisone dosage in all patients. Minimal manifestation status was reached at an average duration of 10 months in 5 patients. No patients were hospitalized for myasthenia gravis exacerbations. There were no major side effects experienced with MTX use. This retrospective analysis suggests that MTX is safe and probably efficacious as a corticosteroid-sparing agent in the management of MG.
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Morren J, Li Y. Maintenance immunosuppression in myasthenia gravis, an update. J Neurol Sci 2020;410:116648.
Karaahmet OZ, Bal A, Dulgeroglu D, Bahceci HK, Cakci A. Methotrexate treatment in myasthenia gravis. J Clinc Neuromusc Dis 2014;16(2):106-107.
Heckmann JM, Rawoot A, Bateman K, Renison R, Badri M. A single-blinded trial of methotrexate versus azathioprine as steroid-sparing agents in generalized myasthenia gravis. BMC Neurol 2011;11:97.
Pasnoor M, He J, Herbelin L, Burns TM, Nations S, Bril V, et al. A randomized controlled trial of methotrexate for patients with generalized myasthenia gravis. Neurology 2016;87(1):57-64.
Jaretzki A, Barohn RJ, Ernstoff RM, Kaminski HJ, Keesey JC, Penn AS, et al. Myasthenia Gravis: Recommendations for clinical research standards. Neurology 2000;55:16-23.
Peck SM, Osserman KE. Studies in bullous diseases: treatment of pemphigus vulgaris with methotrexate, two patients (one with concurrent myasthenia gravis). J Mt Sinai Hosp NY 1969;36(1)71-76.
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Copyright (c) 2021 Yuebing Li, Robert Marquardt, Preston Eibling
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
