{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T23:32:38Z","timestamp":1782862358933,"version":"3.54.5"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,6,25]],"date-time":"2022-06-25T00:00:00Z","timestamp":1656115200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100003157","name":"Myasthenia Gravis Foundation of America","doi-asserted-by":"publisher","award":["4823\u20108809\u20107586.2"],"award-info":[{"award-number":["4823\u20108809\u20107586.2"]}],"id":[{"id":"10.13039\/100003157","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction\/Aims<\/jats:title><jats:p>We studied the progression of myasthenia gravis (MG) disease burden and medication adjustment among MG Patient Registry participants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants diagnosed with MG (age \u226518\u2009years), registered between July 1, 2013 and July 31, 2018 and completing both 6\u2010 and 12\u2010month follow\u2010up surveys, were included in this investigation. Participants were grouped into high\u2010burden (Myasthenia Gravis Activity of Daily Living scale [MG\u2010ADL] score \u22656) and low\u2010burden (MG\u2010ADL &lt;6) groups based on MG\u2010ADL scores at enrollment. Demographics and disease history were compared between groups. MG\u2010ADL score change and medication changes (escalation, no change, de\u2010escalation) between enrollment and 12\u2010month follow\u2010up were compared between groups. Minimal symptom expression (MSE, MG\u2010ADL &lt;2) at 12\u2009months was compared between groups. Logistic regression analysis was performed to study factors associated with MSE at 12\u2009months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 520 participants (56% female) were included in high\u2010burden (n\u00a0=\u00a0248) and low\u2010burden (n\u00a0=\u00a0272) groups. Those in the high\u2010burden group were more likely to be younger, female, and have shorter disease duration. At 12\u2009months, MSE was achieved in 6% of the high\u2010burden group and newly achieved (42 of 201, 21%) or maintained (52 of 71, 73%) in the low\u2010burden group. In the multivariable analysis, being in the high\u2010burden group and use of pyridostigmine were associated with less likelihood of MSE, whereas MG\u2010ADL score improvement (&gt;2 or &gt;20%) at 6\u00a0months significantly increased the likelihood of achieving MSE at 12\u2009months (<jats:italic>P<\/jats:italic>\u00a0=\u2009.0004).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>In both groups, but more so in the high\u2010burden group, patients infrequently achieved MSE after 1\u00a0year of MG treatment. Baseline low disease burden, improvement at 6\u00a0months and no pyridostigmine use were associated with a higher likelihood of MSE at 12\u2009months.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.27659","type":"journal-article","created":{"date-parts":[[2022,6,8]],"date-time":"2022-06-08T08:13:26Z","timestamp":1654676006000},"page":"411-420","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["One\u2010year follow\u2010up of disease burden and medication changes in patients with myasthenia gravis: From the <scp>MG<\/scp> Patient Registry"],"prefix":"10.1002","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0537-9622","authenticated-orcid":false,"given":"Ikjae","family":"Lee","sequence":"first","affiliation":[{"name":"The Neurological Institute of New York Columbia University  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0167-9097","authenticated-orcid":false,"given":"Justin M.","family":"Leach","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inmaculada","family":"Aban","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarrant","family":"McPherson","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra W.","family":"Duda","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, Ra Pharmaceuticals, Inc  Cambridge Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Cutter","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,6,25]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.25205"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2013.10.043"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.14547"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31821e5505"},{"key":"e_1_2_10_6_1","article-title":"Plasma exchange for myasthenia gravis","volume":"2002","author":"Gajdos P","year":"2002","journal-title":"Cochrane Database Syst Rev."},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1329200"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-020-09770-y"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26695"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/CND.0000000000000301"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26104"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.52.7.1487"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.21053"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.25198"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(17)30369-1"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(21)00159-9"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1996.10476973"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(20)30347-1"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26910"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2019.09.019"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.27120"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-018-8995-4"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26069"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12955-020-01549-z"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000507"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000010031"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2021.05.006"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458506075031"}],"container-title":["Muscle &amp; 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