%0 Journal Article %1 citeulike:4544859 %A Gajdos, P. %A Chevret, S. %A Clair, B. %A Tranchant, C. %A Chastang, C. %D 1997 %J Annals of neurology %K neuromuscular, syllabus %N 6 %P 789--796 %R 10.1002/ana.410410615 %T Clinical trial of plasma exchange and high-dose intravenous immunoglobulin in myasthenia gravis. Myasthenia Gravis Clinical Study Group. %U http://dx.doi.org/10.1002/ana.410410615 %V 41 %X We have conducted a trial to randomly assess the efficacy and tolerance of intravenous immunoglobulin (i.v.Ig) or plasma exchange (PE) in myasthenia gravis (MG) exacerbation and to compare two doses of i.v.Ig. Eighty-seven patients with MG exacerbation were randomized to receive either three PE (n = 41), or i.v.Ig (n = 46) 0.4 gm/kg daily further allocated to 3 (n = 23) or 5 days (n = 23). The main end point was the variation of a myasthenic muscular score (MSS) between randomization and day 15. The MSS variation was similar in both groups (median value, +18 in the PE group and +15.5 in the i.v.Ig group, p = 0.65). Similar efficacy, although slightly reduced in the 5-day group was observed with both i.v.Ig schedules. The tolerance of i.v.Ig was better than that of PE with a total of 14 side effects observed in 9 patients, 8 in the PE group and 1 in the i.v.Ig group (p = 0.01). Although our trial failed to show a pronounced difference in the efficacy of both treatments, it exhibited a very limited risk for i.v.Ig. i.v.Ig is an alternative for the treatment of myasthenic crisis. The small sample sizes in our trial, however, could explain why a difference in efficacy was not observed. Further studies are needed to compare PE with i.v.Ig and to determine the optimal dosage of i.v.Ig.

@article{citeulike:4544859, abstract = {We have conducted a trial to randomly assess the efficacy and tolerance of intravenous immunoglobulin (i.v.Ig) or plasma exchange (PE) in myasthenia gravis (MG) exacerbation and to compare two doses of i.v.Ig. Eighty-seven patients with MG exacerbation were randomized to receive either three PE (n = 41), or i.v.Ig (n = 46) 0.4 gm/kg daily further allocated to 3 (n = 23) or 5 days (n = 23). The main end point was the variation of a myasthenic muscular score (MSS) between randomization and day 15. The MSS variation was similar in both groups (median value, +18 in the PE group and +15.5 in the i.v.Ig group, p = 0.65). Similar efficacy, although slightly reduced in the 5-day group was observed with both i.v.Ig schedules. The tolerance of i.v.Ig was better than that of PE with a total of 14 side effects observed in 9 patients, 8 in the PE group and 1 in the i.v.Ig group (p = 0.01). Although our trial failed to show a pronounced difference in the efficacy of both treatments, it exhibited a very limited risk for i.v.Ig. i.v.Ig is an alternative for the treatment of myasthenic crisis. The small sample sizes in our trial, however, could explain why a difference in efficacy was not observed. Further studies are needed to compare PE with i.v.Ig and to determine the optimal dosage of i.v.Ig.}, added-at = {2009-05-19T18:00:18.000+0200}, author = {Gajdos, P. and Chevret, S. and Clair, B. and Tranchant, C. and Chastang, C.}, biburl = {https://www.bibsonomy.org/bibtex/203d0b7338914a850860e0b23460b27a3/earthfare}, citeulike-article-id = {4544859}, comment = {Carey}, description = {CiteULike: Everyone's library}, doi = {10.1002/ana.410410615}, interhash = {1c865196c1d8fd5ee0cd206dfc9dd109}, intrahash = {03d0b7338914a850860e0b23460b27a3}, issn = {0364-5134}, journal = {Annals of neurology}, keywords = {neuromuscular, syllabus}, month = {June}, number = 6, pages = {789--796}, posted-at = {2009-05-19 13:12:32}, priority = {2}, timestamp = {2009-05-19T18:03:27.000+0200}, title = {Clinical trial of plasma exchange and high-dose intravenous immunoglobulin in myasthenia gravis. Myasthenia Gravis Clinical Study Group.}, url = {http://dx.doi.org/10.1002/ana.410410615}, volume = 41, year = 1997 }