Non-Thymomatous Myasthenia Gravis (NTMG) is a long-term neurological disorder associated with muscle weakness, especially the muscles of the eyes and face. Prednisone is a widely accepted treatment for NTMG, but recent evidence suggests a better possible outcome when prednisone is used with thymectomy. The objective of this study is to compare the effects of prednisone plus thymectomy and prednisone alone for patients with NTMG.
This is a blinded, randomized study conducted at 36 centers in 15 countries. The study included a total of 111 patients aged 18-65 years who had generalized NTMG. The participants were randomly assigned in a 1:1 ratio to receive either thymectomy plus prednisone or prednisone alone. The primary outcomes of the study were the Quantitative Myasthenia Gravis (QMG) score and alternate-day prednisone dose.
At 5 years of follow-up, patients in the thymectomy combination group had substantially lower time-weighted mean QMG scores (5.47) and mean alternate-day prednisone dose (24 mg). 34% of patients in the thymectomy combination group and 42% of patients in the prednisone-only group had at least one treatment-related adverse event.
The research concluded that thymectomy plus prednisone showed improved outcomes in both QMG score and alternate-day prednisone dose in patients with non-thymomatous myasthenia gravis, as compared to prednisone alone.
Ref: https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(18)30392-2/fulltext
