scholarly journals Do early prednisolone and other immunosuppressant therapies prevent generalization in ocular myasthenia gravis in Western populations: a systematic review and meta-analysis

2019 ◽  
Vol 12 ◽  
pp. 175628641987652
Author(s):  
Mingxia Li ◽  
Fangfang Ge ◽  
Rongjing Guo ◽  
Zhe Ruan ◽  
Yanwu Gao ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Disease Onset ◽  
Mild Disease ◽  
Ocular Myasthenia ◽  
Randomized Controlled ◽  
Asian Populations ◽  
Prospective Randomized Controlled Trial ◽  
Ocular Myasthenia Gravis

Background: The majority of ocular myasthenia gravis (OMG) patients will progress to generalized myasthenia gravis (GMG), usually within 2 years of disease onset. The aim of this meta-analysis was to evaluate the effect of early prednisolone and other immunosuppressants therapy on the generalization rate in OMG patients. Methods: We searched the CENTRAL, EMBASE, and MEDLINE databases via the Ovid SP database for all relevant publications on 16 July 2018. Results: Eight studies comprising a total of 547 participants were included in our meta-analysis. Compared with pyridostigmine treatment, prednisolone and other immunosuppressants therapy produced an odds ratio (OR) for the development of GMG of 0.19 [95% confidence interval (CI), 0.11–0.30; I2 = 37%], indicating that early prednisolone and other immunosuppressants therapy reduced the generalization rate in OMG by 81%. Conclusions: Early prednisolone and other immunosuppressants therapy can significantly reduce the risk of generalization in OMG patients, and should be considered in newly diagnosed OMG patients. Due to the inclusion of retrospective studies, this noted effect might have been related to corticosteroids, especially when immunosuppressants used at low dosages and in mild disease. Additionally, the data derived from Western populations, thus a prospective randomized controlled trial (RCT) is warranted to confirm this effect of early prednisolone and other immunosuppressants therapy on OMG generalization both in Western and Asian populations.

scholarly journals How about Levetiracetam in Glioblastoma? An Institutional Experience and Meta-Analysis

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3770
Author(s):  
Ramazan Jabbarli ◽  
Yahya Ahmadipour ◽  
Laurèl Rauschenbach ◽  
Alejandro N. Santos ◽  
Marvin Darkwah Darkwah Oppong ◽  
...  
Keyword(s):  
Overall Survival ◽  
Multimodal Treatment ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Multivariable Analysis ◽  
Progression Free Survival ◽  
Free Survival ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
Institutional Experience

Despite multimodal treatment, the prognosis of patients with glioblastoma (GBM) remains poor. Previous studies showed conflicting results on the effect of antiepileptic drugs (AED) on GBM survival. We investigated the associations of different AED with overall survival (OS) and progression-free survival (PFS) in a large institutional GBM cohort (n = 872) treated January 2006 and December 2018. In addition, we performed a meta-analysis of previously published studies, including this study, to summarize the evidence on the value of AED for GBM prognosis. Of all perioperatively administered AED, only the use of levetiracetam (LEV) was associated with longer OS (median: 12.8 vs. 8.77 months, p < 0.0001) and PFS (7 vs. 4.5 months, p = 0.001). In the multivariable analysis, LEV was independently associated with longer OS (aHR = 0.74, p = 0.017) and PFS (aHR = 0.68, p = 0.008). In the meta-analysis with 5614 patients from the present and seven previously published studies, outcome benefit for OS (HR = 0.83, p = 0.02) and PFS (HR = 0.77, p = 0.02) in GBM individuals with LEV was confirmed. Perioperative treatment with LEV might improve the prognosis of GBM patients. We recommend a prospective randomized controlled trial addressing the efficacy of LEV in GBM treatment.

scholarly journals Pure Ocular Myasthenia gravis

2018 ◽  
Vol 02 (01) ◽  
pp. E51-E55
Author(s):  
Lukas Kirzinger ◽  
Sophie Schötz ◽  
Berthold Schalke
Keyword(s):  
Neuromuscular Junction ◽  
Myasthenia Gravis ◽  
Diagnostic Procedure ◽  
Cholinesterase Inhibitors ◽  
Separate Entity ◽  
Ocular Myasthenia ◽  
Randomized Controlled ◽  
Ocular Symptoms ◽  
Randomized Controlled Studies ◽  
Ocular Myasthenia Gravis

AbstractPure ocular myasthenia was always described as a separate entity in historical publications. More than 50% of patients develop generalized symptoms in the course of the disease. Therefore pure ocular symptoms can be the beginning of generalized myasthenia, nevertheless there is a small group of patients who suffer lifelong purely ocular symptoms. The basis, therefore, seems to be special immunological, biochemical and pathophysiological mechanisms leading to specific local changes of the neuromuscular junction. The diagnostic procedure is hampered as antibodies against acethylcholine receptors and MuSK can be demonstrated in less than 50% of these patients. Therapy of pure ocular myasthenia does not differ fundamentally from other subgroups of myasthenia gravis and is implemented with cholinesterase inhibitors, steroids and common immunosuppressants. Thymomectomy is not recommended in general, but randomized controlled studies are lacking.

Abstract #1154: Ocular Myasthenia Gravis in the Setting of Graves’ Disease

2016 ◽  
Vol 22 ◽  
pp. 277-278
Author(s):  
Lima Lawrence ◽  
Aleida Rodriguez ◽  
Tahira Yasmeen ◽  
Erin Drever
Keyword(s):  
Myasthenia Gravis ◽  
Graves Disease ◽  
Ocular Myasthenia ◽  
Ocular Myasthenia Gravis

The diagnosis and management of ocular myasthenia gravis

2019 ◽  
Vol 5 (1-2) ◽  
pp. 3-8
Author(s):  
Gordon Plant
Keyword(s):  
Myasthenia Gravis ◽  
Severe Form ◽  
Differential Diagnostics ◽  
Diagnosis And Management ◽  
Ocular Myasthenia ◽  
Clinical Presentations ◽  
Ocular Myasthenia Gravis

Ocular myasthenia is not the most severe form of myasthenia but it might cause certain difficulties to diagnose. In this article, we shall discuss the clinical presentations of ocular myasthenia, its differential diagnostics, examinations and management. Keywords: ocular myasthenia gravis, diagnosis, examination, management.

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