{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T23:45:21Z","timestamp":1789429521787,"version":"build-2803163510"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"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":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Clinical guidelines for treating myasthenia gravis (MG) recommend avoiding certain therapies because of a risk of exacerbating MG. We evaluated use of statins and other classically contraindicated therapies and their impact on healthcare outcomes among patients with MG in France.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was an observational, retrospective, longitudinal cohort study using data from the French national health insurance database. Adult patients with MG\u2010related claims from 2013 to 2020 were included. The first MG claim date was the index date, with follow\u2010up until end\u2010of\u2010study or death. Multivariable regression models evaluated the risk of intensive care unit (ICU) admission for MG or death during periods of exposure versus nonexposure to contraindicated treatments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 14,459 individuals with MG, 12,954 (89.6%) received a contraindicated treatment during follow\u2010up, and 4160 (28.8%) received statins. In multivariable regression analyses, exposure to any contraindicated treatment was not significantly associated with risk of ICU admission for MG (hazard ratio [HR] 1.038; 95% confidence interval [CI] 0.968\u20131.113;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009not significant) but was associated with significantly higher risk of death (HR 1.167; 95% CI 1.075\u20131.266;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) versus nonexposure. In contrast, statins were associated with a greater risk of ICU admission (HR 1.133; 95% CI 1.065\u20131.205;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) but lower risk of death (HR 0.626; 95% CI 0.565\u20130.694;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This large, real\u2010world study suggests that for some contraindicated medications, including statins, longer\u2010term mortality benefits are likely to outweigh short\u2010term risks of exacerbating MG.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70504","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T11:16:58Z","timestamp":1769167018000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Myasthenia Gravis Outcomes After Use of Statins and Other Contraindicated Treatments: Results From the French National Insurance Database"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9599-6573","authenticated-orcid":false,"given":"Guilhem","family":"Sol\u00e9","sequence":"first","affiliation":[{"name":"Neuromuscular Reference Center AOC, Neurology and Neuromuscular Diseases Department, Pellegrin Hospital Bordeaux University Hospitals, Filnemus, Euro\u2010NMD  Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5282-6707","authenticated-orcid":false,"given":"Jean Philippe","family":"Camdessanch\u00e9","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neuromuscular Disease Reference Center, H\u00f4pital Nord University Hospital of Saint\u2010\u00c9tienne  Saint\u2010\u00c9tienne France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7211-4694","authenticated-orcid":false,"given":"Shahram","family":"Attarian","sequence":"additional","affiliation":[{"name":"Reference Center for Neuromuscular Disease and ALS, Timone University Hospital Aix\u2010Marseille University, CHU Timone  Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Ciumas","sequence":"additional","affiliation":[{"name":"argenx  Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0900-8351","authenticated-orcid":false,"given":"C\u00e9cile","family":"Blein","sequence":"additional","affiliation":[{"name":"argenx  Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2373-1872","authenticated-orcid":false,"given":"Benjamin","family":"Grenier","sequence":"additional","affiliation":[{"name":"Heva  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3003-8459","authenticated-orcid":false,"given":"El\u00e9onore","family":"Herquelot","sequence":"additional","affiliation":[{"name":"Heva  Lyon 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  Le Kremlin\u2010Bic\u00eatre France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,23]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.2147\/ndt.s296714"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurol.2024.02.392"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12883\u2010022\u201002692\u20104"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12974\u2010022\u201002448\u20104"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10071537"},{"key":"e_1_2_10_7_1","unstructured":"\u201cMyasth\u00e9nie Autoimmune. Protocole National de Diagnostic et de Soins (PNDS) Centre de r\u00e9f\u00e9rences de pathologie neuromusculaire Paris Est\u201d(2015) https:\/\/www.has\u2010sante.fr\/upload\/docs\/application\/pdf\/2015\u201007\/pnds_\u2010_myasthenie_autoimmune.pdf."},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.0000000000011124"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.03.009"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab484"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26637"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.21074"},{"issue":"4","key":"e_1_2_10_13_1","first-page":"344","article-title":"Eye on Statins: A Comprehensive Review","volume":"110","author":"Olson E. 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