Evaluation of the Clinical and Prognostic Characteristics of Myasthenia Gravis Patients Followed Up in a Tertiary Neuromuscular Disease Center in Thrace Region of Turkey

Abstract

Objective: This study is aimed at comparing the clinical, serological, and prognostic characteristics of myasthenia gravis (MG) subtypes based on data obtained from patients monitored at a tertiary neuromuscular disease center in Türkiye, within the framework of MGFA and MGFA-PIS classifications. The limited number of published studies from Türkiye in this field enhances the originality and potential contribution of this study to the regional literature on the local patient profile.

Methods: A total of 190 patients who were monitored between 2012 and 2023 and diagnosed with MG according to clinical, serological, or electrophysiological criteria were included in the study. Patients were classified according to antibody profile, involved muscle group, and age at disease onset. Clinical and demographic characteristics, treatment strategies, and prognosis were assessed.

Results: In the classification of MG based on age at onset, 78.3% of patients in the early-onset MG (EOMG) subgroup were female, while 57.9% of those in the late-onset MG (LOMG) subgroup were male (p < 0.001). Significant differences were found between the EOMG and LOMG groups in the use of azathioprine and corticosteroids (p = 0.006 and p = 0.002, respectively). LOMG was more frequently observed in both the ocular MG (OMG) and generalized MG (GMG) groups. Electrophysiological abnormalities were detected more frequently in the GMG group (p = 0.045). Among patients initially diagnosed with OMG, 41.2% developed generalization during a median follow-up period of 5 years.

Conclusion: This study revealed significant differences among MG subtypes in terms of clinical features, autoantibody profiles, and treatment requirements. The MGFA and MGFA-PIS classifications offer useful tools for individualized treatment planning. The findings provide valuable insights into the potential role of early immunosuppressive therapy in reducing the risk of generalization in patients with OMG.