Initial Treatment Response in Ocular Myasthenia Gravis: A Comparison Between Low and Moderate Doses of Prednisolone

Thanatporn Threetong,1,2 Anuchit Poonyathalang,1 Pisit Preechawat,1 Panitha Jindahra,3 Tanyatuth Padungkiatsagul,1 Kavin Vanikieti1 1Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Department of Ophthalmology, Faculty of Medicine, Buraph...

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Autores principales:	Threetong T, Poonyathalang A, Preechawat P, Jindahra P, Padungkiatsagul T, Vanikieti K
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	ocular myasthenia gravis low dose moderate dose prednisolone treatment outcome Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/ae461ac90c6e4e4d8eef8162def6e81c
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spelling	oai:doaj.org-article:ae461ac90c6e4e4d8eef8162def6e81c2021-12-02T10:29:51ZInitial Treatment Response in Ocular Myasthenia Gravis: A Comparison Between Low and Moderate Doses of Prednisolone1177-5483https://doaj.org/article/ae461ac90c6e4e4d8eef8162def6e81c2020-07-01T00:00:00Zhttps://www.dovepress.com/initial-treatment-response-in-ocular-myasthenia-gravis-a-comparison-be-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Thanatporn Threetong,1,2 Anuchit Poonyathalang,1 Pisit Preechawat,1 Panitha Jindahra,3 Tanyatuth Padungkiatsagul,1 Kavin Vanikieti1 1Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Department of Ophthalmology, Faculty of Medicine, Burapha University, Chonburi, Thailand; 3Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, ThailandCorrespondence: Tanyatuth PadungkiatsagulDepartment of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Bangkok 10400, ThailandTel +662 201 1526Fax +662 201 2729Email blu_c16@hotmail.comPurpose: To evaluate the initial treatment response to low doses of prednisolone, compared with moderate doses, in ocular myasthenia gravis (OMG).Patients and Methods: A retrospective chart review of patients with adult-onset (age ≥ 15 years old) OMG, who were treated with prednisolone, was conducted. Subjects were divided into two groups according to their prednisolone dosing regimen. The low-dose group was defined as those with an average 12-week cumulative dose of prednisolone < 0.435 mg/kg/day and the moderate-dose group averaged 0.435– 1.000 mg/kg/day. The primary outcome of interest was the comparison of clinical response to prednisolone at 12 weeks between the low-dose and moderate-dose groups. The secondary outcome was the difference in adverse events between treatment groups.Results: Of 34 subjects, 16 subjects (47.1%) were male. The mean age at onset was 44.0± 18.1 years. The most common presenting ocular feature was ptosis with ophthalmoplegia (22 subjects, 64.7%), followed by isolated ptosis (nine subjects, 26.5%) and isolated ophthalmoplegia (three subjects, 8.8%). Half of the subjects were treated with low-dose prednisolone and the other half were treated with moderate-dose prednisolone. There were no substantial differences in baseline characteristics between treatment groups. After 12 weeks of treatment, nine of 17 subjects (52.9%) and 13 of 17 subjects (76.5%) in the low- and moderate-dose groups, respectively, were regarded as responsive to the prednisolone treatment (P=0.28). Adverse events were exclusively observed in the moderate-dose group.Conclusion: Treatment of OMG with an average 12-week cumulative dose of prednisolone < 0.435 mg/kg/day (low dose) shows a comparable responsive outcome to 0.435– 1.000 mg/kg/day of prednisolone (moderate dose). Treating OMG with low-dose prednisolone can minimize prednisolone-related adverse events. However, a prospective randomized controlled trial with a larger study population is warranted in order to gain more insight into the proper dosage of prednisolone for OMG.Keywords: ocular myasthenia gravis, low dose, moderate dose, prednisolone, treatment outcomeThreetong TPoonyathalang APreechawat PJindahra PPadungkiatsagul TVanikieti KDove Medical Pressarticleocular myasthenia gravislow dosemoderate doseprednisolonetreatment outcomeOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 2051-2056 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	ocular myasthenia gravis low dose moderate dose prednisolone treatment outcome Ophthalmology RE1-994
spellingShingle	ocular myasthenia gravis low dose moderate dose prednisolone treatment outcome Ophthalmology RE1-994 Threetong T Poonyathalang A Preechawat P Jindahra P Padungkiatsagul T Vanikieti K Initial Treatment Response in Ocular Myasthenia Gravis: A Comparison Between Low and Moderate Doses of Prednisolone
description	Thanatporn Threetong,1,2 Anuchit Poonyathalang,1 Pisit Preechawat,1 Panitha Jindahra,3 Tanyatuth Padungkiatsagul,1 Kavin Vanikieti1 1Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Department of Ophthalmology, Faculty of Medicine, Burapha University, Chonburi, Thailand; 3Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, ThailandCorrespondence: Tanyatuth PadungkiatsagulDepartment of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Bangkok 10400, ThailandTel +662 201 1526Fax +662 201 2729Email blu_c16@hotmail.comPurpose: To evaluate the initial treatment response to low doses of prednisolone, compared with moderate doses, in ocular myasthenia gravis (OMG).Patients and Methods: A retrospective chart review of patients with adult-onset (age ≥ 15 years old) OMG, who were treated with prednisolone, was conducted. Subjects were divided into two groups according to their prednisolone dosing regimen. The low-dose group was defined as those with an average 12-week cumulative dose of prednisolone < 0.435 mg/kg/day and the moderate-dose group averaged 0.435– 1.000 mg/kg/day. The primary outcome of interest was the comparison of clinical response to prednisolone at 12 weeks between the low-dose and moderate-dose groups. The secondary outcome was the difference in adverse events between treatment groups.Results: Of 34 subjects, 16 subjects (47.1%) were male. The mean age at onset was 44.0± 18.1 years. The most common presenting ocular feature was ptosis with ophthalmoplegia (22 subjects, 64.7%), followed by isolated ptosis (nine subjects, 26.5%) and isolated ophthalmoplegia (three subjects, 8.8%). Half of the subjects were treated with low-dose prednisolone and the other half were treated with moderate-dose prednisolone. There were no substantial differences in baseline characteristics between treatment groups. After 12 weeks of treatment, nine of 17 subjects (52.9%) and 13 of 17 subjects (76.5%) in the low- and moderate-dose groups, respectively, were regarded as responsive to the prednisolone treatment (P=0.28). Adverse events were exclusively observed in the moderate-dose group.Conclusion: Treatment of OMG with an average 12-week cumulative dose of prednisolone < 0.435 mg/kg/day (low dose) shows a comparable responsive outcome to 0.435– 1.000 mg/kg/day of prednisolone (moderate dose). Treating OMG with low-dose prednisolone can minimize prednisolone-related adverse events. However, a prospective randomized controlled trial with a larger study population is warranted in order to gain more insight into the proper dosage of prednisolone for OMG.Keywords: ocular myasthenia gravis, low dose, moderate dose, prednisolone, treatment outcome
format	article
author	Threetong T Poonyathalang A Preechawat P Jindahra P Padungkiatsagul T Vanikieti K
author_facet	Threetong T Poonyathalang A Preechawat P Jindahra P Padungkiatsagul T Vanikieti K
author_sort	Threetong T
title	Initial Treatment Response in Ocular Myasthenia Gravis: A Comparison Between Low and Moderate Doses of Prednisolone
title_short	Initial Treatment Response in Ocular Myasthenia Gravis: A Comparison Between Low and Moderate Doses of Prednisolone
title_full	Initial Treatment Response in Ocular Myasthenia Gravis: A Comparison Between Low and Moderate Doses of Prednisolone
title_fullStr	Initial Treatment Response in Ocular Myasthenia Gravis: A Comparison Between Low and Moderate Doses of Prednisolone
title_full_unstemmed	Initial Treatment Response in Ocular Myasthenia Gravis: A Comparison Between Low and Moderate Doses of Prednisolone
title_sort	initial treatment response in ocular myasthenia gravis: a comparison between low and moderate doses of prednisolone
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/ae461ac90c6e4e4d8eef8162def6e81c
work_keys_str_mv	AT threetongt initialtreatmentresponseinocularmyastheniagravisacomparisonbetweenlowandmoderatedosesofprednisolone AT poonyathalanga initialtreatmentresponseinocularmyastheniagravisacomparisonbetweenlowandmoderatedosesofprednisolone AT preechawatp initialtreatmentresponseinocularmyastheniagravisacomparisonbetweenlowandmoderatedosesofprednisolone AT jindahrap initialtreatmentresponseinocularmyastheniagravisacomparisonbetweenlowandmoderatedosesofprednisolone AT padungkiatsagult initialtreatmentresponseinocularmyastheniagravisacomparisonbetweenlowandmoderatedosesofprednisolone AT vanikietik initialtreatmentresponseinocularmyastheniagravisacomparisonbetweenlowandmoderatedosesofprednisolone
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Initial Treatment Response in Ocular Myasthenia Gravis: A Comparison Between Low and Moderate Doses of Prednisolone

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