Real-world outcomes of myasthenia gravis management: a cross-sectional study at a Korean tertiary center.

Abstract

Introduction: The clinical course and treatment response of myasthenia gravis (MG) vary widely, requiring a comprehensive understanding of treatment outcomes. However, real-world data on Korean MG patients remain limited. This study aimed to evaluate treatment outcomes in Korean MG patients at a specific cross-sectional time point.

Methods: This retrospective analysis included MG patients who had outpatient visits between October 2023 and September 2024. We assessed treatment outcomes at the index date, including the proportion achieving MM-5-defined as minimal manifestations or better with corticosteroid use ≤5 mg/day - and the proportion meeting criteria for refractory MG.

Results: A total of 668 patients were included. At the index date, 16.3% were in pharmacologic remission, 45.1% in minimal manifestation, and 4.9% showed worsening disease. Overall, 48.1% achieved MM-5. The MM-5 rate was 51.9% among those treated with one immunosuppressant but declined to 17.1% in those who had been treated with three. MM-5 was achieved in 41.7% of patients with a history of myasthenic crisis and 49.0% of those without. The median MG-ADL score was 2.0; 33.7% scored 0, while 13.9% scored ≥6. The median prednisolone dose was 5.0 mg/day; 67.2% received ≤5 mg, and 9.0% received ≥15 mg. Depending on the definition used, 1.0% to 22.8% were classified as refractory.

Conclusion: This study provides real-world insights into treatment outcomes in Korean MG patients. While about half achieved stable disease with conventional therapies, a substantial proportion remained inadequately controlled, underscoring ongoing treatment challenges.