scholarly journals Methotrexate Use in Generalized Autoimmune Myasthenia Gravis: A Case series

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Preston Eibling ◽  
Yuebing Li ◽  
Robert Marquardt
Keyword(s):  
Side Effects ◽  
Myasthenia Gravis ◽  
Retrospective Analysis ◽  
Acetylcholine Receptor ◽  
Average Duration ◽  
Case Series ◽  
Immunosuppressive Medication ◽  
Autoimmune Myasthenia ◽  
Sparing Effect ◽  
Steroid Sparing

Methotrexate (MTX) is an inexpensive and well-tolerated immunosuppressive medication that is used anecdotally in autoimmune myasthenia gravis (MG). However, the efficacy in MG is unclear at this time. This retrospective analysis describes six patients with acetylcholine receptor antibody positive MG who were treated with MTX and corticosteroids. The efficacy of MTX was measured by steroid-sparing effect and the Myasthenia Gravis Foundation of America (MGFA) classification. MTX initiation was associated with a reduction in prednisone dosage in all patients. Minimal manifestation status was reached at an average duration of 10 months in 5 patients.  No patients were hospitalized for myasthenia gravis exacerbations. There were no major side effects experienced with MTX use.  This retrospective analysis suggests that MTX is safe and probably efficacious as a corticosteroid-sparing agent in the management of MG.

Mycophenolate mofetil and myasthenia gravis

Lupus ◽  
2005 ◽  
Vol 14 (3_suppl) ◽  
pp. 46-49 ◽  
Author(s):  
E Ciafaloni
Keyword(s):  
Mycophenolate Mofetil ◽  
Side Effects ◽  
Myasthenia Gravis ◽  
Neuromuscular Transmission ◽  
Autoimmune Disorder ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Multicenter Trials ◽  
Sparing Effect ◽  
Steroid Sparing

Myasthenia gravis (MG) represents the prototypic autoimmune disorder with well characterized immunopathology. Advances in the diagnosis and treatment of this neuromuscular transmission disorder have significantly improved the management of myasthenic patients. Unfortunately the currently available immunomodulating treatments have significant side effects and some patients do not tolerate them or adequately respond to them. Therefore the possibility of a new immunosuppressant agent that is safe, effective and has steroid-sparing effect is very appealing. Mycophenolate mofetil (MMF) has shown promising effects in MG patients in preliminary studies and is currently being studied in two prospective, randomized, double-blind, placebo controlled, multicenter trials to better establish its role in the treatment of MG.

scholarly journals Mycophenolate Mofetil for the Treatment of Autoimmune Hepatitis in Patients Refractory to Standard Therapy

2004 ◽  
Vol 18 (5) ◽  
pp. 321-326 ◽  
Author(s):  
Shane M Devlin ◽  
Mark G Swain ◽  
Stefan J Urbanski ◽  
Kelly W Burak
Keyword(s):  
Mycophenolate Mofetil ◽  
Autoimmune Hepatitis ◽  
Alanine Aminotransferase ◽  
Standard Therapy ◽  
Conventional Treatment ◽  
Case Series ◽  
Therapeutic Options ◽  
Sparing Effect ◽  
Histological Remission ◽  
Steroid Sparing

There are limited therapeutic options available for patients with autoimmune hepatitis in whom conventional treatment fails. A case series of five patients unresponsive to or unable to take azathioprine, 6-mercaptopurine or corticosteroids who were treated with mycophenolate mofetil (MMF) is reported. While on MMF, alanine aminotransferase normalized or remained normal in all patients. MMF had a steroid-sparing effect and histological remission was demonstrated in one patient after seven months of MMF. One patient experienced an uncomplicated episode of pyelonephritis. In conclusion, MMF can effectively induce and maintain remission in refractory autoimmune hepatitis patients.

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