{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T17:25:45Z","timestamp":1783013145269,"version":"3.54.6"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2002,6,10]],"date-time":"2002-06-10T00:00:00Z","timestamp":1023667200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2002,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Twenty\u2010three myasthenia gravis (MG) subjects, mean (SD) age 41.6 years (14), showing poor disease control or steroid\u2010related side effects, received treatment for 12 months with intravenous cyclophosphamide (CP; <jats:italic>n<\/jats:italic> = 12) or placebo (PL; <jats:italic>n<\/jats:italic> = 11) in a randomized, double\u2010blind trial. Pulses were given monthly at an initial dose of 500 mg\/m<jats:sup>2<\/jats:sup> of body surface, and titrated according to changes of peripheral muscle strength or side effects. Changes of muscle strength, steroid and pyridostigmine requirements, and development of ventilatory failure or swallowing impairment were evaluated at 0, 3, 6, and 12 months. No differences were observed between groups at baseline. Statistically significant reductions of methylprednisone doses were noted in both groups but were more pronounced in subjects receiving CP than PL at 6 months (<jats:italic>P<\/jats:italic> &lt; 0.05) and at 12 months (<jats:italic>P<\/jats:italic> &lt; 0.03). At 12 months, five subjects on CP had tapered off their steroids whereas no subject on PL achieved further reductions (<jats:italic>P<\/jats:italic> &lt; 0.03). Four CP subjects were not receiving steroids 36 months after completing the study and three other CP subjects had stopped pyridostigmine. CP improved muscle strength at 3 and 6 months, and this reached statistical significance compared to PL at 12 months mainly in the bulbar and masticatory (<jats:italic>P<\/jats:italic> &lt; 0.009) and extraocular muscles (<jats:italic>P<\/jats:italic> &lt; 0.03). Ventilatory failure was noted in one subject on CP (due to bronchopneumonia) and two on PL (due to muscle weakness). No significant increases of CP\u2010related side effects were observed. Thus, this study suggests that intravenous pulses of CP allow reductions of systemic steroids usage without muscle strength deterioration or CP\u2010related side effects. \u00a9 2002 Wiley Periodicals,  Inc. Muscle Nerve 26: 31\u201336, 2002<\/jats:p>","DOI":"10.1002\/mus.10133","type":"journal-article","created":{"date-parts":[[2002,10,6]],"date-time":"2002-10-06T11:53:08Z","timestamp":1033905188000},"page":"31-36","source":"Crossref","is-referenced-by-count":109,"title":["Use of intravenous pulsed cyclophosphamide in severe, generalized myasthenia gravis"],"prefix":"10.1002","volume":"26","author":[{"given":"Lucas","family":"Gustavo De Feo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Schottlender","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N\u00e9stor A.","family":"Martelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N\u00e9stor A.","family":"Molfino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2002,6,10]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780160405"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-106-1-79"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1998.tb11015.x"},{"key":"e_1_2_7_5_2","doi-asserted-by":"crossref","first-page":"1316","DOI":"10.1212\/WNL.33.10.1316","article-title":"Myasthenia gravis: long\u2010term correlation of binding and bungarotioxin\u2010blocking antibodies against acethylcholine receptors with changes of disease severity","volume":"33","author":"Besinger UA","year":"1983","journal-title":"Neurology"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(92)92292-N"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-112-9-674"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(98)00184-2"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-510X(97)05370-7"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(90)90366-L"},{"key":"e_1_2_7_11_2","doi-asserted-by":"crossref","first-page":"2453","DOI":"10.4049\/jimmunol.128.6.2453","article-title":"Suppression of B lymphocytes function by cyclophosphamide","volume":"128","author":"Cupps TR","year":"1982","journal-title":"J Immunol"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-96-6-728"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199406233302507"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1987.tb51317.x"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.55.1.16"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1987.tb51325.x"},{"key":"e_1_2_7_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)90699-8"},{"key":"e_1_2_7_18_2","first-page":"347","article-title":"Azathioprine experience in severe, generalized, recalcitrant myasthenia gravis","volume":"52","author":"Kornfeld P","year":"1985","journal-title":"Mt Sinai J Med"},{"key":"e_1_2_7_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0733-8619(05)70335-2"},{"key":"e_1_2_7_20_2","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/S0889-857X(21)01003-6","article-title":"Intravenous cyclophosphamide therapy of severe systemic lupus erythematosus","volume":"15","author":"McCune WJ","year":"1989","journal-title":"Rheum Dis Clin North Am"},{"key":"e_1_2_7_21_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198806023182203"},{"key":"e_1_2_7_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/0165-5728(87)90050-6"},{"key":"e_1_2_7_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(99)00310-0"},{"key":"e_1_2_7_24_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1956.02960380001001"},{"key":"e_1_2_7_25_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.50.6.1778"},{"key":"e_1_2_7_26_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410150316"},{"key":"e_1_2_7_27_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.31.1.32"},{"key":"e_1_2_7_28_2","first-page":"247","article-title":"Monthly intravenous cyclophosphamide in the treatment of severe lupus erythematosus","volume":"2","author":"Sessoms SL","year":"1984","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_7_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780170104"},{"key":"e_1_2_7_30_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198703193161205"},{"key":"e_1_2_7_31_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1993.tb22937.x"},{"key":"e_1_2_7_32_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198703193161205"},{"key":"e_1_2_7_33_2","first-page":"506","article-title":"Mechanism of immunosuppression: effects of cyclophosphamide on lymphocytes","volume":"80","author":"Winkelstein A","year":"1972","journal-title":"J Lab Clin Med"}],"container-title":["Muscle &amp; Nerve"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fmus.10133","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.10133","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,19]],"date-time":"2023-11-19T12:43:56Z","timestamp":1700397836000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/mus.10133"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2002,6,10]]},"references-count":32,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2002,7]]}},"alternative-id":["10.1002\/mus.10133"],"URL":"https:\/\/doi.org\/10.1002\/mus.10133","archive":["Portico"],"relation":{},"ISSN":["0148-639X","1097-4598"],"issn-type":[{"value":"0148-639X","type":"print"},{"value":"1097-4598","type":"electronic"}],"subject":[],"published":{"date-parts":[[2002,6,10]]}}}