A retrospective study carried out in two Italian expert centres in 66 patients aged over 65 with autoimmune myasthenia with thymoma, without anti-MuSK, showed :
- significant neurological improvement after thymectomy in 88% of patients, corresponding to a post-intervention MGFA status of stable complete remission (6% of cases), pharmacological remission (16.7%) or minimal manifestations (65.2%),
- no link between the evolution of myasthenia after the operation and the age of onset of the disease, its severity or the type of pharmacological treatment prior to the operation, the surgical approach, the size of the thymoma or its stage.
The authors argue in favour of full-scale clinical trials to assess the efficacy of thymectomy in myasthenia without thymoma after the age of 65, as was done in the MGTX trial in patients under 65.
