{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:15:25Z","timestamp":1787019325787,"version":"build-2736575974"},"reference-count":26,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"S&T Program of Hebei Central guidance for local scientific and technological development funding projects","award":["No. 246Z7706G"],"award-info":[{"award-number":["No. 246Z7706G"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["No. 82274582"],"award-info":[{"award-number":["No. 82274582"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Key Laboratory Construction Subsidy Fund Project","award":["No. 236790017H"],"award-info":[{"award-number":["No. 236790017H"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Neurol Disord"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The necessity and optimal duration of post-thymectomy immunoregulatory medication (IM) in myasthenia gravis (MG) remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This study aimed to evaluate whether IM is required after thymectomy in MG patients and to determine the appropriate duration of IM in patients without postoperative deterioration by comparing long-term clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>This triple-center, retrospective study included 1248 MG patients who underwent thymectomy. Among these patients, we compared outcomes between 483 patients without post-thymectomy IM and 765 patients receiving IM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Efficacy outcomes included post-thymectomy deterioration and minimal manifestation status (MMS) at 1\u2009year. Safety outcomes, tumor growth, and serious complications were assessed between groups. Subgroup analyses were performed in mild cases (Myasthenia Gravis Foundation of America clinical classification (MGFA) \u2a7d2a at discharge), patients receiving IM for &gt;1\u2009year, and patients receiving IM for &gt;2\u2009years. Propensity score matching (PSM) was conducted for validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Relative to 438 MG patients underwent thymectomy with no-IM therapy, 756 thymectomized MG patients receiving concomitant IM showed significantly superior outcomes, including lower deterioration (hazard ratio (HR)\u2009=\u20090.44, adjusted\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), lower deteriorated MGFA class (adjusted coefficient\u2009=\u20090.94,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and higher odds of achieving MMS at 1\u2009year (odds ratio\u2009=\u20092.06, adjusted\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). No significant differences were observed in tumor development (3\u2009years:\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.78; 5\u2009years:\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.27) or serious complications (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.53). Similar trends were observed across subgroups. Among patients without postoperative deterioration, IM longer than 1\u2009year reduced deterioration risk compared with \u2a7d1\u2009year (HR\u2009=\u20090.67 (0.50\u20130.91),\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.01), whereas extending IM beyond 2\u2009years offered no additional benefit (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.137). PSM analysis confirmed these findings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our real-world analysis of 1248 MG patients suggests that thymectomy alone is not sufficient to achieve satisfactory outcomes. Post-thymectomy IM is recommended for at least 1\u2009year, while extending treatment beyond 2\u2009years appears to offer no further advantage in patients without deterioration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17562864261415757","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T06:43:46Z","timestamp":1770792226000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Thymectomy with or without maintenance therapy for myasthenia gravis patients: a tri-center, real-world study"],"prefix":"10.1177","volume":"19","author":[{"given":"Hao","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moli","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutong","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyu","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zihao","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0846-2851","authenticated-orcid":false,"given":"Chun-Sheng","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui-Ning","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-He","family":"Zhang","sequence":"additional","affiliation":[{"name":"Myasthenia Gravis Center, People\u2019s Hospital Shijiazhuang, Shijiazhuang, Hebei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Liu","sequence":"additional","affiliation":[{"name":"Myasthenia Gravis Center, People\u2019s Hospital Shijiazhuang, Shijiazhuang, Hebei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ti","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9675-4637","authenticated-orcid":false,"given":"Fu-Dong","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, Tianjin 300000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9218-3219","authenticated-orcid":false,"given":"Guo-Yan","family":"Qi","sequence":"additional","affiliation":[{"name":"Myasthenia Gravis Center, People\u2019s Hospital Shijiazhuang, No. 365 Jianhua St., Shijiazhuang, Hebei 050011, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,10]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1602489"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivt510"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1080\/14737175.2019.1600404"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-017-3058-7"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd-22-1589"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000010031"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30392-2"},{"key":"e_1_3_4_9_2","article-title":"Guideline for the management of myasthenic syndromes","volume":"16","author":"Wiendl H","year":"2023","unstructured":"Wiendl H, Abicht A, Chan A, et al. 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