{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T01:06:38Z","timestamp":1790643998389,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,10,15]],"date-time":"2020-10-15T00:00:00Z","timestamp":1602720000000},"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":[[2021,2]]},"abstract":"<jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Long\u2010term treatment of myasthenia gravis (MG) includes symptomatic and course\u2010modifying therapies that target the immune system. Recently, both intravenous immunoglobulin (IVIG) and subcutaneous immunoglobulin (SCIG) have emerged as viable options for chronic therapy, considering the favourable safety\u2013efficacy profile and possible immunosuppressant sparing properties. The aim was to investigate the outcomes of the long\u2010term care of generalized MG with immunoglobulin (Ig).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a retrospective, repeated\u2010measures design study. Charts of generalized MG patients, treated with IVIG\/SCIG for at least 6\u00a0months, from January 2015 to January 2020, were analysed. The primary outcome was the mean change in Myasthenia Gravis Impairment Index (MGII) after treatment with Ig, comparing baseline to IVIG and SCIG treatment periods. Secondary outcomes included the changes in pyridostigmine, immunosuppressive medications and patient\u2010reported outcome \u2018percentage of normal\u2019 (0%\u2013100%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010four patients were treated with chronic Ig therapy (30 IVIG\/SCIG, three SCIG, one IVIG). The mean durations of IVIG and SCIG periods were 21.8\u00a0\u00b1\u00a019.4 (range 3\u201364) months and 19.5\u00a0\u00b1\u00a011.3 (range 5\u201345) months respectively. There was a significant reduction in MGII scores (27.7\u00a0\u00b1\u00a015.7 baseline; 22.0\u00a0\u00b1\u00a017.4 IVIG period; 19.5\u00a0\u00b1\u00a018.1 SCIG period;<jats:italic>F<\/jats:italic>\u00a0=\u00a017.9; d.f.\u00a0=\u00a01.7;<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01), pyridostigmine and immunosuppressant use (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.00). The outcome \u2018percentage of normal\u2019 had a significant positive association with both treatments (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.00).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study results suggest that patients can be successfully transitioned to IVIG and from IVIG to SCIG in the chronic treatment of generalized MG with reductions in impairments and use of other medications and improvement in overall status with Ig therapy. Prospective, randomized studies are needed to clarify costs and comparative effectiveness.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.14547","type":"journal-article","created":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T06:34:52Z","timestamp":1600842892000},"page":"639-646","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Chronic immunoglobulin maintenance therapy in myasthenia gravis"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3306-3265","authenticated-orcid":false,"given":"M.","family":"Alcantara","sequence":"first","affiliation":[{"name":"Ellen and Martin Prosserman Centre for Neuromuscular Diseases Toronto General Hospital University Health Network University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Sarpong","sequence":"additional","affiliation":[{"name":"Ellen and Martin Prosserman Centre for 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