{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:59:15Z","timestamp":1791910755022,"version":"4.3.4"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,11,7]],"date-time":"2016-11-07T00:00:00Z","timestamp":1478476800000},"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":["Euro J of Neurology"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>A single, oral dose of 3 mg\/day tacrolimus, approved for myasthenia gravis (<jats:styled-content style=\"fixed-case\">MG<\/jats:styled-content>) treatment in Japan, was shown to reduce steroid dose and anti\u2010acetylcholine receptor (<jats:styled-content style=\"fixed-case\">AC<\/jats:styled-content>hR) antibody titers as well as to improve <jats:styled-content style=\"fixed-case\">MG<\/jats:styled-content> symptoms. However, no studies have investigated the association between tacrolimus concentration and its clinical efficacy in <jats:styled-content style=\"fixed-case\">MG<\/jats:styled-content>. In this study, we aimed to determine the optimal tacrolimus concentration for <jats:styled-content style=\"fixed-case\">MG<\/jats:styled-content> treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The trough tacrolimus concentration in 51 patients with <jats:styled-content style=\"fixed-case\">MG<\/jats:styled-content> (positive for anti\u2010<jats:styled-content style=\"fixed-case\">AC<\/jats:styled-content>hR antibody, <jats:italic>n<\/jats:italic> = 48; negative for anti\u2010<jats:styled-content style=\"fixed-case\">AC<\/jats:styled-content>hR and anti\u2010muscle\u2010specific tyrosine kinase antibodies, <jats:italic>n<\/jats:italic> = 3) who received 3 mg\/day tacrolimus for more than 1 year was measured using a chemiluminescent enzyme immunoassay. The clinical characteristics of patients with <jats:styled-content style=\"fixed-case\">MG<\/jats:styled-content> as well as the dose of prednisolone used before and after tacrolimus treatment were evaluated retrospectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median trough tacrolimus concentration was 5.4 (range, 2.9\u20137.6) ng\/mL, which was correlated with \u2018minimal manifestation or better status\u2019 (<jats:italic>P<\/jats:italic> = 0.0190, <jats:italic>r<\/jats:italic> = 0.3273) and the reduction in anti\u2010<jats:styled-content style=\"fixed-case\">AC<\/jats:styled-content>hR antibody 1 year after tacrolimus initiation (<jats:italic>P<\/jats:italic> = 0.0170, <jats:italic>r<\/jats:italic> = 0.3465). When the cut\u2010off value for tacrolimus was defined as 4.8 ng\/mL using a receiver operating characteristic curve, patients with adequate tacrolimus concentration (\u22654.8 ng\/mL) showed more reduction in anti\u2010<jats:styled-content style=\"fixed-case\">AC<\/jats:styled-content>hR antibody titers and more improvement in MG\u2010related activities in daily life scores. More patients with adequate tacrolimus concentration achieved \u2018minimal manifestation or better status\u2019 compared with those with low tacrolimus concentration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>An adequate tacrolimus concentration is required for better <jats:styled-content style=\"fixed-case\">MG<\/jats:styled-content> prognosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.13189","type":"journal-article","created":{"date-parts":[[2016,11,7]],"date-time":"2016-11-07T09:42:07Z","timestamp":1478511727000},"page":"270-275","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Adequate tacrolimus concentration for myasthenia gravis treatment"],"prefix":"10.1111","volume":"24","author":[{"given":"T.","family":"Kanai","sequence":"first","affiliation":[{"name":"Department of Neurology Graduate School of Medicine Chiba University 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