Based on data from the French National Health Data System (SNDS), the Stamina study reviewed the management of two groups of adults with autoimmune myasthenia gravis:
- the ‘prevalent’ population, of 22,079 patients diagnosed before 31 December 2019,
- the ‘incident’ population, comprising 2,661 patients diagnosed in 2012 or 2013.
A study of their follow-up shows that :
- the proportion of patients receiving long-term treatment for myasthenia ranged from 53.1% in 2019 for the prevalent population to 84.6% in the incident population over a follow-up period of six years, with the significant proportion of patients not receiving treatment partly due to moderate ocular forms and remissions ;
- anticholinesterase agents are the specific treatment most frequently prescribed in both groups, followed by non-steroidal immunosuppressants,
- the trend is towards cortisone sparing, with a gradual reduction in the number of patients on corticosteroids over the years,
- the variability of the disease over time makes it necessary to readjust treatment, with almost 80% of patients in the incident population having had at least one change of therapeutic family in six years, the average number of changes being 2.89 per patient over the period,
- 14.3% of patients in the prevalent population experienced at least one exacerbation of their myasthenia in 2019, and 2.1% at least one myasthenic crisis.
These data illustrate the need for close monitoring and personalised treatment to improve disease control. It remains to be seen whether the possibilities offered by the new anti-myasthenia biotherapies will change the situation in real life in the years to come.
