Treat ocular myasthenia with or without immunosuppressive therapy?

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Analysis of the records of 135 patients treated at an expert centre in Japan for an ocular form of autoimmune myasthenia found :

  • 89% of patients on anticholinesterase drugs,
  • 67% of patients were on one or more immunosuppressants (most often oral corticosteroids, tacrolimus, cyclosporine, etc.), with a wide variation in prescriptions from one hospital to another,
  • 8 patients went into remission, six on anticholinesterase drugs and the other two spontaneously,
  • a significantly lower proportion of refractory disease on immunosuppressants (2/90) than without (8/45),
  • a lower rate of generalised myasthenia gravis in the hospitals that prescribed the most immunotherapy,
  • persistence of symptoms in almost 61% of patients, all treatments combined.

While these results do not really lead to a clear-cut conclusion, they do argue in favour of the possible benefits of immunosuppressants in ocular myasthenia.

 

Immunotherapy for ocular myasthenia gravis: an observational study in Japan. Narita T, Nakane S, Nagaishi A et al. Ther Adv Neurol Disord. 2023 Apr.

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