{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T03:10:32Z","timestamp":1790651432010,"version":"4.1.0"},"reference-count":16,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,1,14]],"date-time":"2019-01-14T00:00:00Z","timestamp":1547424000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Introduction<\/jats:italic>\n                    : A randomized trial demonstrated benefit from thymectomy in nonthymomatous acetylcholine receptor (AChR)\u2010antibody positive myasthenia gravis (MG). Uncontrolled observational and histologic studies suggest thymectomy may not be efficacious in anti\u2013muscle\u2010specific kinase (MuSK)\u2010MG.\n                    <jats:italic>Methods<\/jats:italic>\n                    : The therapeutic impact of thymectomy was evaluated from data collected for a multicenter, retrospective blinded review of rituximab in MuSK\u2010MG.\n                    <jats:italic>Results<\/jats:italic>\n                    : Baseline characteristics were similar between thymectomy (\n                    <jats:italic>n<\/jats:italic>\n                    = 26) and nonthymectomy (\n                    <jats:italic>n<\/jats:italic>\n                    = 29) groups, including treatment with rituximab (42% vs. 45%). At last visit, 35% of thymectomy subjects reached the primary endpoint, a Myasthenia Gravis Foundation of America (MGFA) post\u2010intervention status (PIS) score of minimal manifestations (MM) or better, compared with 55% of controls (\n                    <jats:italic>P<\/jats:italic>\n                    = 0.17). After controlling for age at onset of MG, rituximab, prednisone, and intravenous immunoglobulin\/plasma exchange treatment, thymectomy was not associated with greater likelihood of favorable clinical outcome (odds ratio = 0.43, 95% confidence interval 0.12\u20131.53,\n                    <jats:italic>P<\/jats:italic>\n                    = 0.19).\n                    <jats:italic>Discussion<\/jats:italic>\n                    : Thymectomy was not associated with additional clinical improvement in this multicenter cohort of MuSK\u2010MG patients.\n                    <jats:italic>Muscle Nerve<\/jats:italic>\n                    59:404\u2013410, 2019\n                  <\/jats:p>","DOI":"10.1002\/mus.26404","type":"journal-article","created":{"date-parts":[[2018,12,21]],"date-time":"2018-12-21T17:05:23Z","timestamp":1545411923000},"page":"404-410","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":79,"title":["Thymectomy may not be associated with clinical improvement in MuSK myasthenia gravis"],"prefix":"10.1002","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6969-4846","authenticated-orcid":false,"given":"Katherine M.","family":"Clifford","sequence":"first","affiliation":[{"name":"Larner College of Medicine University of Vermont, 1 South Prospect Street  Burlington Vermont 05401 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa D.","family":"Hobson\u2010Webb","sequence":"additional","affiliation":[{"name":"Department of Neurology, Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Benatar","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Miami Health System  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ted M.","family":"Burns","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Virginia School of Medicine  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5546-0221","authenticated-orcid":false,"given":"Carolina","family":"Barnett","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Toronto School of Medicine  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas J.","family":"Silvestri","sequence":"additional","affiliation":[{"name":"Department of Neurology, University at Buffalo Jacobs School of Medicine &amp; Biomedical Sciences  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7136-8617","authenticated-orcid":false,"suffix":"Jr","given":"James F.","family":"Howard","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of North Carolina School of Medicine  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Visser","sequence":"additional","affiliation":[{"name":"Department of Neurology, Oregon Health &amp; Science University  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian A.","family":"Crum","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Nowak","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Beekman","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Ruzhansky","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I\u2010Hweii Amy","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael T.","family":"Pulley","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Florida  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon M.","family":"Laboy","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Florida  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa A.","family":"Fellman","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Miami Health System  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diantha B.","family":"Howard","sequence":"additional","affiliation":[{"name":"Larner College of Medicine University of Vermont, 1 South Prospect Street  Burlington Vermont 05401 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2651-2349","authenticated-orcid":false,"given":"Noah A.","family":"Kolb","sequence":"additional","affiliation":[{"name":"Larner College of Medicine University of Vermont, 1 South Prospect Street  Burlington Vermont 05401 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shane M.","family":"Greene","sequence":"additional","affiliation":[{"name":"Larner College of Medicine University of Vermont, 1 South Prospect Street  Burlington Vermont 05401 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamatha","family":"Pasnoor","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Kansas Medical Center  Kansas City Kansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mazen M.","family":"Dimachkie","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Kansas Medical Center  Kansas City Kansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Barohn","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Kansas Medical Center  Kansas City Kansas 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Nerve"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fmus.26404","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.26404","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T23:09:23Z","timestamp":1694387363000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/mus.26404"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1,14]]},"references-count":16,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,4]]}},"alternative-id":["10.1002\/mus.26404"],"URL":"https:\/\/doi.org\/10.1002\/mus.26404","archive":["Portico"],"relation":{},"ISSN":["0148-639X","1097-4598"],"issn-type":[{"value":"0148-639X","type":"print"},{"value":"1097-4598","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1,14]]},"assertion":[{"value":"2018-06-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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