{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:58:59Z","timestamp":1791910739463,"version":"4.3.4"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,2,20]],"date-time":"2023-02-20T00:00:00Z","timestamp":1676851200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["62171299"],"award-info":[{"award-number":["62171299"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Use of tacrolimus in mild to moderate myasthenia gravis (MG) is generally limited to glucocorticoid\u2010refractory cases; the advantage of mono\u2010tacrolimus over mono\u2010glucocorticoids is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included mild to moderate MG patients treated with mono\u2010tacrolimus (mono\u2010TAC) or mono\u2010glucocorticoids (mono\u2010GC). The correlation between the immunotherapy options and the treatment efficacy and side effects were examined in 1:1 propensity\u2010score matching. The main outcome was time to minimal manifestations status or better (MMS or better). Secondary outcomes include time to relapse, the mean changes in Myasthenia Gravis\u2010specific Activities of Daily Living (MG\u2010ADL) scores and the rate of adverse events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Baseline characteristics showed no difference between matched groups (49 matched pairs). There were no differences in median time to MMS or better between the mono\u2010TAC group and mono\u2010GC group (5.1 vs. 2.8\u2009months: unadjusted hazard ratio [HR], 0.73; 95% CI, 0.46\u20131.16; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.180), as well as in median time to relapse (data unavailable for the mono\u2010TAC group since 44 of 49 [89.8%] participants remained in MMS or better; 39.7\u2009months in mono\u2010GC group: unadjusted HR, 0.67; 95% CI, 0.23\u20131.97; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.464). Changes in MG\u2010ADL scores between the two groups were similar (mean differences, 0.3; 95% CI, \u22120.4 to 1.0; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.462). The rate of adverse events was lower in the mono\u2010TAC group compared to the mono\u2010GC group (24.5% vs. 55.1%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.002).<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Mono\u2010tacrolimus performs superior tolerability with non\u2010inferior efficacy compared to mono\u2010glucocorticoids in mild to moderate myasthenia gravis patients who refuse or have a contraindication to glucocorticoids.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.51746","type":"journal-article","created":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T05:47:44Z","timestamp":1676958464000},"page":"589-598","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Comparison between mono\u2010tacrolimus and mono\u2010glucocorticoid in the treatment of myasthenia gravis"],"prefix":"10.1002","volume":"10","author":[{"given":"Zhirong","family":"Fan","sequence":"first","affiliation":[{"name":"Department of Neurology, Xuanwu Hospital Capital Medical University  Beijing China"},{"name":"Department of Neurology Xijing Hospital, Fourth Military Medical University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Lei","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xuanwu Hospital Capital Medical University  Beijing China"},{"name":"Department of Neurology Beijing Jishuitan Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengyao","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xuanwu Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xuanwu Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nairong","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xuanwu Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xuanwu Hospital Capital Medical University  Beijing China"},{"name":"Department of Neurology Tianjin 4th Centre Hospital  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xuanwu Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Di","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xuanwu Hospital Capital Medical University  Beijing 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