{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:58:22Z","timestamp":1791910702240,"version":"4.3.4"},"reference-count":13,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T00:00:00Z","timestamp":1725408000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81201371"],"award-info":[{"award-number":["81201371"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81903221"],"award-info":[{"award-number":["81903221"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004735","name":"Natural Science Foundation of Hunan Province","doi-asserted-by":"publisher","award":["2021JJ40986"],"award-info":[{"award-number":["2021JJ40986"]}],"id":[{"id":"10.13039\/501100004735","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004735","name":"Natural Science Foundation of Hunan Province","doi-asserted-by":"publisher","award":["2023JJ41021"],"award-info":[{"award-number":["2023JJ41021"]}],"id":[{"id":"10.13039\/501100004735","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>We investigated the proper timing, efficacy and safety of tacrolimus for juvenile myasthenia gravis (JMG).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective cohort study for JMG patients treated with tacrolimus at Xiangya Hospital, Central South University, Changsha, China from 2010 to 2023. The clinical information of patients with a follow\u2010up of more than 1\u2009year was collected. Comparisons of clinical features between groups of patients who achieved therapeutic goal and those who did not achieve therapeutic goal as well as between groups of patients treated with tacrolimus within or after 1\u2009year from JMG onset was carried out.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010three patients were enrolled, of whom 28 achieved therapeutic goal. Tacrolimus reduced glucocorticoids (GC) dosages for the 28 cases and 15 cases discontinued GC completely. Generalized myasthenia gravis (GMG) subtype had an association with a group of patients who achieved therapeutic goal (<jats:italic>p<\/jats:italic>\u2009=\u20090.001). Median duration from JMG onset to tacrolimus use was 10.50\u2009months for those who achieved therapeutic goal and 36.00\u2009months for those who did not achieve therapeutic goal (<jats:italic>p<\/jats:italic>\u2009=\u20090.010). The median Myasthenia Gravis Activities of Daily Living (MG\u2010ADL) score improved significantly (<jats:italic>p<\/jats:italic>\u2009=\u20090.003). The initiation of tacrolimus within 1\u2009year of JMG onset showed an association with achievement of therapeutic goal (<jats:italic>p<\/jats:italic>\u2009=\u20090.026). GMG subtype showed an association with a group of patients who received tacrolimus within 1\u2009year (<jats:italic>p<\/jats:italic>\u2009=\u2009&lt;0.001). Tacrolimus side effects were tolerable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The provision of tacrolimus within 1\u2009year of JMG onset is effective and safe.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.16466","type":"journal-article","created":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T10:39:11Z","timestamp":1725446351000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Treatment of juvenile myasthenia gravis with tacrolimus: A cohort study"],"prefix":"10.1111","volume":"31","author":[{"given":"Guoli","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Pediatrics Xiangya Hospital, Central South University  Changsha China"},{"name":"Hunan Intellectual and Developmental Disabilities Research Center  Changsha China"},{"name":"Clinical Research Center for Children Neurodevelopmental Disabilities of Hunan Province Xiangya Hospital, Central South University  Changsha China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7932-9292","authenticated-orcid":false,"given":"Miriam","family":"Kessi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Xiangya Hospital, Central South University  Changsha China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Xiangya Hospital, Central South University  Changsha China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Xiangya Hospital, Central South University  Changsha China"},{"name":"Hunan Intellectual and Developmental Disabilities Research Center  Changsha China"},{"name":"Clinical Research Center for Children Neurodevelopmental Disabilities of Hunan Province Xiangya Hospital, Central South University  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South University  Changsha China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Xiangya Hospital, Central South University  Changsha China"},{"name":"Hunan Intellectual and Developmental Disabilities Research Center  Changsha China"},{"name":"Clinical Research Center for Children Neurodevelopmental Disabilities of Hunan Province Xiangya Hospital, Central South University  Changsha China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7192-6308","authenticated-orcid":false,"given":"Fei","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Xiangya Hospital, Central South University  Changsha China"},{"name":"Hunan Intellectual and Developmental Disabilities Research Center  Changsha China"},{"name":"Clinical Research Center for Children Neurodevelopmental Disabilities of Hunan Province Xiangya 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