{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T23:59:20Z","timestamp":1783468760171,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","license":[{"start":{"date-parts":[[2021,11,20]],"date-time":"2021-11-20T00:00:00Z","timestamp":1637366400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Science and Technology Innovation Guidance Project of Hunan Province","award":["2020SK53009"],"award-info":[{"award-number":["2020SK53009"]}]},{"name":"Science and Technology Innovation Guidance Project of Hunan Province","award":["kq2007037"],"award-info":[{"award-number":["kq2007037"]}]},{"name":"Science and Technology Innovation Guidance Project of Hunan Province","award":["81771364"],"award-info":[{"award-number":["81771364"]}]},{"name":"Changsha Municipal Natural Science Foundation","award":["2020SK53009"],"award-info":[{"award-number":["2020SK53009"]}]},{"name":"Changsha Municipal Natural Science Foundation","award":["kq2007037"],"award-info":[{"award-number":["kq2007037"]}]},{"name":"Changsha Municipal Natural Science Foundation","award":["81771364"],"award-info":[{"award-number":["81771364"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["2020SK53009"],"award-info":[{"award-number":["2020SK53009"]}],"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":["kq2007037"],"award-info":[{"award-number":["kq2007037"]}],"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":["81771364"],"award-info":[{"award-number":["81771364"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Immunology Research"],"published-print":{"date-parts":[[2021,11,20]]},"abstract":"<jats:p>Background. Tacrolimus is a second-line immunosuppressant in myasthenia gravis (MG) therapy, which is mainly used in combination with corticosteroids to reduce steroid dose and maintain the effect of immunotherapy. However, few studies have focused on the effect of tacrolimus as single-agent immunotherapy on achieving minimal manifestation status (MMS). Thus, this study is aimed at exploring the efficacy and influencing factors of tacrolimus as single-agent immunotherapy in MG. Methods. Clinical data of 75 nonthymoma MG patients treated with tacrolimus single-agent as initial immunotherapy were retrospectively analyzed. The therapeutic effect was evaluated by Myasthenia Gravis Foundation of America postintervention status. Clinical factors affecting the achievement of MMS and treatment reactivity of different MG subtypes were determined by Cox regression analysis. Results. Tacrolimus was generally safe, with only two patients (2.7%) switching medications due to side effects. 32% of patients had improved symptoms after 1 month of treatment. 69.2% of patients achieved MMS or better after one year. The <jats:inline-formula>\n                     <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mtext>age<\/a:mtext>\n                        <a:mo>&lt;<\/a:mo>\n                        <a:mn>39<\/a:mn>\n                     <\/a:math>\n                  <\/jats:inline-formula> years old, <jats:inline-formula>\n                     <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mtext>QMG<\/c:mtext>\n                        <c:mtext>\u2009<\/c:mtext>\n                        <c:mtext>score<\/c:mtext>\n                        <c:mo>&lt;<\/c:mo>\n                        <c:mn>11<\/c:mn>\n                     <\/c:math>\n                  <\/jats:inline-formula> points, and <jats:inline-formula>\n                     <e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                        <e:mtext>AChR<\/e:mtext>\n                        <e:mo>\u2212<\/e:mo>\n                        <e:mtext>Ab<\/e:mtext>\n                        <e:mtext>\u2009<\/e:mtext>\n                        <e:mtext>titer<\/e:mtext>\n                        <e:mo>&lt;<\/e:mo>\n                        <e:mn>8.07<\/e:mn>\n                        <e:mtext>\u2009<\/e:mtext>\n                        <e:mtext>nmol<\/e:mtext>\n                        <e:mo>\/<\/e:mo>\n                        <e:mtext>L<\/e:mtext>\n                     <\/e:math>\n                  <\/jats:inline-formula> were indicative of a favorable response, which was independent of gender, course of the disease. As for MG subtypes, ocular and seronegative MG showed better treatment sensitivity. Conclusions. Tacrolimus as single-agent immunotherapy takes effect quickly and can effectively enable nonthymoma MG patients to achieve MMS. Tacrolimus can be used alone for the initial immunotherapy of MG patients, especially for young, mild, and low antibody titer patients.<\/jats:p>","DOI":"10.1155\/2021\/9138548","type":"journal-article","created":{"date-parts":[[2021,11,20]],"date-time":"2021-11-20T23:20:07Z","timestamp":1637450407000},"page":"1-7","source":"Crossref","is-referenced-by-count":13,"title":["Tacrolimus as Single-Agent Immunotherapy and Minimal Manifestation Status in Nonthymoma Myasthenia Gravis"],"prefix":"10.1155","volume":"2021","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3683-6873","authenticated-orcid":true,"given":"Weiwei","family":"Duan","sequence":"first","affiliation":[{"name":"Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410008 Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6595-2921","authenticated-orcid":true,"given":"Yuyao","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410008 Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6622-9631","authenticated-orcid":true,"given":"Wanlin","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410008 Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4260-3163","authenticated-orcid":true,"given":"Song","family":"Ouyang","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Hospital of Changsha, University of South China, Changsha, 410005 Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8690-2544","authenticated-orcid":true,"given":"Huan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410008 Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0000000000000596"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1177\/1756286420949808"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1558975"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)00145-3"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000020832"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1080\/14656566.2019.1682548"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2016.08.057"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-016-8045-z"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.2174\/1389200219666180129151948"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-00860-y"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000002790"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.55.1.16"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1998.tb11015.x"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.1111\/ene.13189"},{"key":"15","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S319500"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-04-0713"},{"key":"17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2019.02.004"},{"key":"18","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26708"},{"key":"19","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2016030342"},{"key":"20","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.06180519"},{"key":"21","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2014.06.005"},{"key":"22","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2007.07.022"},{"key":"23","doi-asserted-by":"publisher","DOI":"10.1177\/1759720X11419038"},{"key":"24","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1602678"},{"key":"25","doi-asserted-by":"publisher","DOI":"10.1002\/mus.21640"},{"key":"26","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-010-5746-6"},{"key":"27","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.00660"},{"key":"28","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-019-02642-z"},{"key":"29","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-019-02803-0"}],"container-title":["Journal of Immunology Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/jir\/2021\/9138548.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/jir\/2021\/9138548.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/jir\/2021\/9138548.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,20]],"date-time":"2021-11-20T23:20:15Z","timestamp":1637450415000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/jir\/2021\/9138548\/"}},"subtitle":[],"editor":[{"given":"Jixin","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,11,20]]},"references-count":29,"alternative-id":["9138548","9138548"],"URL":"https:\/\/doi.org\/10.1155\/2021\/9138548","relation":{},"ISSN":["2314-7156","2314-8861"],"issn-type":[{"value":"2314-7156","type":"electronic"},{"value":"2314-8861","type":"print"}],"subject":[],"published":{"date-parts":[[2021,11,20]]}}}