{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T15:49:45Z","timestamp":1785253785913,"version":"3.55.0"},"reference-count":28,"publisher":"Wiley","license":[{"start":{"date-parts":[[2024,7,26]],"date-time":"2024-07-26T00:00:00Z","timestamp":1721952000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction\/Aims<\/jats:title><jats:p>Females with generalized myasthenia gravis (gMG) report lower quality of life (QoL) and have more severe disease than males. Sex differences in disease characteristics exist, however whether there are sex differences in the treatment of gMG that may contribute to QoL disparities is unknown. Our objective is to determine whether there are sex differences in the treatment of gMG.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a single\u2010center retrospective study of people diagnosed with gMG at the University of Calgary between 1997 and 2021. Primary outcome was proportion starting treatment and secondary outcome was time from diagnosis to treatment initiation. Treatments included pyridostigmine, prednisone, steroid sparing therapies (azathioprine, mycophenolate mofetil [MMF], methotrexate [MTX], or tacrolimus), intravenous immunoglobulin (IVIg), plasmapheresis, rituximab, eculizumab, cyclosporine, stem cell transplantation, and thymectomy. Multivariable logistic and Cox proportional hazards regression models were used to examine treatment associations with sex, adjusted for time from onset to diagnosis, age at diagnosis, presence of thymoma, and antibody status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 179 people with gMG were included (41.9% female). Odds of starting treatment were not statistically associated with sex after adjustment for confounders and correction for multiple testing. Results of the secondary analysis using time to treatment initiation as the outcome were similar.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>We found no sex differences in odds of starting treatment or time to treatment initiation that might explain previously observed sex\u2010based differences in QoL. Future work should capture physician and patient treatment preferences that may influence disease management.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.28210","type":"journal-article","created":{"date-parts":[[2024,7,26]],"date-time":"2024-07-26T07:04:35Z","timestamp":1721977475000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["No sex\u2010based differences in odds of starting or time to treatment of generalized myasthenia gravis: A single center cohort study"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9574-1412","authenticated-orcid":false,"given":"Benjamin","family":"Beland","sequence":"first","affiliation":[{"name":"Department of Clinical Neurosciences, Cumming School of Medicine University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0746-7223","authenticated-orcid":false,"given":"Tefani","family":"Perera","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Cumming School of Medicine University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9483-975X","authenticated-orcid":false,"given":"Angela","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Cumming School of Medicine University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie","family":"Greenfield","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Cumming School of Medicine University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1594-5923","authenticated-orcid":false,"given":"Lawrence","family":"Korngut","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Cumming School of Medicine University of Calgary  Calgary Alberta Canada"},{"name":"Hotchkiss Brain Institute, Cumming School of Medicine University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8268-5677","authenticated-orcid":false,"given":"Gordon","family":"Jewett","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Cumming School of Medicine University of Calgary  Calgary Alberta Canada"},{"name":"Hotchkiss Brain Institute, Cumming School of Medicine University of Calgary  Calgary Alberta 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Physician"},{"issue":"2","key":"e_1_2_11_24_1","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1002\/mus.28006","article-title":"Incidence and prevalence of myasthenia gravis in the United States: a claims\u2010based analysis","volume":"69","author":"Rodrigues E","year":"2024","journal-title":"Muscle Nerve"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2016.44"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2013.12.004"},{"key":"e_1_2_11_27_1","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2023.1214041","article-title":"Diagnosis and therapy of myasthenia gravis\u2010the patients' perspective: a cross\u2010sectional study","volume":"14","author":"Sobierajski T","year":"2023","journal-title":"Front Neurol"},{"issue":"1","key":"e_1_2_11_28_1","doi-asserted-by":"crossref","DOI":"10.1212\/CPJ.0000000000200244","article-title":"Exploring factors that prolong the diagnosis of myasthenia gravis","volume":"14","author":"Nguyen M","year":"2024","journal-title":"Neurol Clin Pract"},{"key":"e_1_2_11_29_1","unstructured":"CADTH C.A.f.D.a.T.i.H.Canadian Drug Expert Committee recommendation: Eculizumab (Soliris \u2014 Alexion Pharma Canada Corp.): Indication: Adult patients with refractory generalized myasthenia gravis [October 2020].https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK567285\/."}],"container-title":["Muscle &amp; 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