{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T13:43:30Z","timestamp":1779371010285,"version":"3.53.0"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T00:00:00Z","timestamp":1730678400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100018748","name":"Argenx","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018748","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":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Few data are available on the course of myasthenia gravis (MG) regarding disease severity and stability over time in real\u2010world settings. This study used the French National Health Insurance Database (SNDS) to assess markers of disease severity in patients with MG longitudinally.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients with MG\u2010related claims in the SNDS between 2013 and 2020 were identified. Patients were followed for up to 8\u2009years after the first claim. Intensive care unit (ICU) stays, treatment with intravenous immunoglobulin (IVIg) or plasma exchange (PE), and death were documented throughout the follow\u2010up period. Standardized mortality rates were estimated, and mortality\u2010related variables were identified using a Cox model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In all, 14,459 individuals constituted the full study population, including 6354 incident patients. In the incident population, 2199 (34.6%) were admitted to ICUs at least once, principally during the first year after the index date (<jats:italic>N<\/jats:italic>\u2009=\u20091477; 23.3%). This proportion decreased progressively to reach 3.0% in the seventh year. A total of 2817 patients received IVIg and 432 PE, again principally in the first year. In the full study population, the standardized mortality rate was 1.08 (95% confidence interval [CI] 1.03\u20131.13), being lower in men (0.95, 95% CI 0.89\u20131.02) than in women (1.15, 95% CI 1.07\u20131.23) and in patients aged &gt;65\u2009years (1.06, 95% CI 1.01\u20131.11) than in younger patients (1.50, 95% CI 1.24\u20131.76). Male gender, older age and higher comorbidity were independently associated with mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A subgroup of patients with MG require ICU admission and rescue therapy with IVIg or PE, indicative of poor disease control. New therapies are needed to improve disease control and reduce disease burden.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.16518","type":"journal-article","created":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T10:24:46Z","timestamp":1730715886000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Tracking myasthenia gravis severity over time: Insights from the French health insurance claims database"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7211-4694","authenticated-orcid":false,"given":"Shahram","family":"Attarian","sequence":"first","affiliation":[{"name":"Reference Centre for Neuromuscular Disease and ALS Timone University Hospital, Aix\u2010Marseille University, CHU Timone, Filnemus, Euro\u2010NMD  Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5282-6707","authenticated-orcid":false,"given":"Jean\u2010Philippe","family":"Camdessanch\u00e9","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neuromuscular Disease Reference Centre, H\u00f4pital Nord University Hospital of Saint\u2010\u00c9tienne  Saint\u2010\u00c9tienne France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1012-9783","authenticated-orcid":false,"given":"Andoni","family":"Echaniz\u2010Laguna","sequence":"additional","affiliation":[{"name":"Department of Neurology, APHP, CHU de Bic\u00eatre INSERM U1195, Paris\u2010Saclay University  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Ciumas","sequence":"additional","affiliation":[{"name":"Argenx France  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9cile","family":"Blein","sequence":"additional","affiliation":[{"name":"Argenx France  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Grenier","sequence":"additional","affiliation":[{"name":"HEVA  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9599-6573","authenticated-orcid":false,"given":"Guilhem","family":"Sol\u00e9","sequence":"additional","affiliation":[{"name":"Neurology and Neuromuscular Diseases Department, Neuromuscular Reference Centre AOC, Pellegrin Hospital Bordeaux University Hospitals  Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,4]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-019-0079-y"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)05186-2"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12967-021-03185-7"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurol.2023.09.004"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S296714"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-8-129"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/cei.12217"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-022-02692-4"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-021-10759-4"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.4233"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.respe.2017.05.004"},{"key":"e_1_2_11_13_1","volume-title":"\u00c9pid\u00e9miologie de la myasth\u00e9nie en France: analyse d'une base EGB (\u00e9chantillon g\u00e9n\u00e9raliste de b\u00e9n\u00e9ficiaires) repr\u00e9sentatif des donn\u00e9es du SNIIRAM et \u00e9tude sur la cohorte du centre de r\u00e9f\u00e9rence des maladies neuromusculaires rares du CHU de Clermont\u2010Ferrand","author":"Feral L","year":"2020"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000471"},{"key":"e_1_2_11_16_1","unstructured":"INSEE. 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