{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T01:16:51Z","timestamp":1789521411863,"version":"build-2803163510"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,1]]},"abstract":"\n Background and Objectives:<\/jats:title>\n There is paucity of studies on long-term remission of autoimmune generalized myasthenia gravis (MG) from Southeast Asia. We report the outcome predictors of generalized MG and also evaluate the influence of high- versus low-dose prednisolone and prednisolone with or without azathioprine (AZA).<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Fifty-seven patients with generalized MG were included, who completed 2 years of follow-up. Demographic information, comorbidities, Myasthenia Gravis Foundation of America (MGFA) class at baseline and follow-up, acetylcholine receptor (AChR) and muscle-specific kinase antibodies, decremental response, thymectomy, and treatments were recorded. Maximum doses of prednisolone, AZA, and acetylcholinesterase inhibitors were noted. The predictors of MGFA 0 at 3 and 6 months and minimal manifestation (MM) status at 2 years were evaluated.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n MGFA 0 was achieved by 27 (47.4%) patients at 3 months, 35 (61.4%) patients at 6 months, and 46 (80.7%) patients at 12 months. At 2 years, 48 (84.2%) patients achieved the MM status and none achieved complete stable or pharmacologic remission. On multivariate analysis, AChR antibody titer (adjusted odds ratio [AOR] 1.08, 95% confidence interval [CI] 1.006\u20131.167;\n P<\/jats:italic>\n = 0.03) and MG activity of daily living (MGADL) at 6 months (AOR 1.28, 95% CI 1.066\u20131.558;\n P<\/jats:italic>\n = 0.01) predicted the MM status. Maximum dose of prednisolone and adjunctive AZA did not predict the MM status.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n About 84.2% of patients with generalized MG, especially those with a low AChR antibody titer and MGADL < 4 at 6 months, achieved the MM status at 2 years.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/aian.aian_386_24","type":"journal-article","created":{"date-parts":[[2025,1,26]],"date-time":"2025-01-26T23:00:09Z","timestamp":1737932409000},"page":"58-65","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Outcome Predictors of Generalized Myasthenia Gravis: A Prospective Observational Study"],"prefix":"10.4103","volume":"28","author":[{"given":"Jayantee","family":"Kalita","sequence":"first","affiliation":[{"name":"Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nagendra B","family":"Gutti","sequence":"additional","affiliation":[{"name":"Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faim","family":"Ahamed","sequence":"additional","affiliation":[{"name":"Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,1,24]]},"reference":[{"key":"R1-20250220","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1038\/nrneurol.2016.44","article-title":"Myasthenia gravis-autoantibody characteristics and their implications for therapy","volume":"12","author":"Gilhus","year":"2016","journal-title":"Nat Rev Neurol"},{"key":"R2-20250220","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/S1474-4422(09)70063-8","article-title":"Autoimmune myasthenia gravis: Emerging clinical and biological heterogeneity","volume":"8","author":"Meriggioli","year":"2009","journal-title":"Lancet Neurol"},{"key":"R3-20250220","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1212\/WNL.0000000000002790","article-title":"International consensus guidance for management of myasthenia gravis: Executive summary","volume":"87","author":"Sanders","year":"2016","journal-title":"Neurology"},{"key":"R4-20250220","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1016\/j.jocn.2005.12.041","article-title":"Clinical predictors of steroid-induced exacerbation in myasthenia gravis","volume":"13","author":"Bae","year":"2006","journal-title":"J Clin Neurosci"},{"key":"R5-20250220","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.jns.2018.10.018","article-title":"Predictive score for oral corticosteroid-induced initial worsening of seropositive generalized myasthenia gravis","volume":"396","author":"Kanai","year":"2019","journal-title":"J Neurol Sci"},{"key":"R6-20250220","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1056\/NEJM197401102900204","article-title":"Gradually increasing doses of prednisone in myasthenia gravis. Reducing the hazards of treatment","volume":"290","author":"Seybold","year":"1974","journal-title":"N Engl J Med"},{"key":"R7-20250220","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/j.ncl.2018.01.011","article-title":"Treatment of myasthenia gravis","volume":"36","author":"Farmakidis","year":"2018","journal-title":"Neurol Clin"},{"key":"R8-20250220","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1002\/ana.410150615","article-title":"Azathioprine in the treatment of myasthenia gravis","volume":"15","author":"Witte","year":"1984","journal-title":"Ann Neurol"},{"key":"R9-20250220","doi-asserted-by":"crossref","first-page":"1778","DOI":"10.1212\/WNL.50.6.1778","article-title":"A randomized double-blind trial of prednisolone alone or with azathioprine in myasthenia gravis. 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Task Force of the Medical Scientific Advisory Board of the Myasthenia Gravis Foundation of America","volume":"70","author":"Jaretzki","year":"2000","journal-title":"Ann Thorac Surg"},{"key":"R24-20250220","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1002\/mus.21883","article-title":"The MG-QOL15 for following the health-related quality of life of patients with myasthenia gravis","volume":"43","author":"Burns","year":"2011","journal-title":"Muscle Nerve"},{"key":"R25-20250220","article-title":"Clinical Neurophysiology: Nerve Conduction, Electromyography, Evoked Potentials","author":"Misra","year":"2019","journal-title":"Elsevier Health Sciences"},{"key":"R26-20250220","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/0022-510X(91)90260-E","article-title":"Prognosis of myasthenia gravis: A multicenter follow-up study of 844 patients","volume":"106","author":"Beghi","year":"1991","journal-title":"J Neurol Sci"},{"key":"R27-20250220","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1196\/annals.1254.054","article-title":"Myasthenia gravis (MG): Epidemiological data and prognostic factors","volume":"998","author":"Mantegazza","year":"2003","journal-title":"Ann N Y Acad Sci"},{"key":"R28-20250220","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1007\/s004150050142","article-title":"Prognosis of myasthenia gravis: A retrospective study of 380 patients","volume":"244","author":"Cosi","year":"1997","journal-title":"J Neurol."},{"key":"R29-20250220","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1136\/jnnp-2020-325511","article-title":"Rate of change in acetylcholine receptor antibody levels predicts myasthenia gravis outcome","volume":"92","author":"Kojima","year":"2021","journal-title":"J Neurol Neurosurg Psychiatry"}],"container-title":["Annals of Indian Academy of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aian.aian_386_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:08:02Z","timestamp":1787774882000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aian.aian_386_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":28,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/aian.aian_386_24","relation":{},"ISSN":["0972-2327","1998-3549"],"issn-type":[{"value":"0972-2327","type":"print"},{"value":"1998-3549","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2024-05-13","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-29","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}