了解重症肌无力结局的种族差异：EXPLORE-MG注册经验。

IF 3.2 Q3 CLINICAL NEUROLOGY

Neurology. Clinical practice Pub Date : 2025-08-01 Epub Date: 2025-06-18 DOI:10.1212/CPJ.0000000000200503

Nilay P McLaren, Bhaskar Roy, Richard J Nowak

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引用次数: 0

摘要

背景和目的：过去的研究报道了重症肌无力（MG）患者的种族和民族差异，但要么是10岁以上的患者，要么只是检查小样本。为了更好地了解这些差异，我们使用EXPLORE-MG注册表，对MG患者的特征和长期结局的种族和民族差异进行了回顾性队列研究。方法：在2001年1月至2023年10月期间，通过抗体血清阳性、单纤维肌电图阳性或重复性神经刺激减少等一项或多项评估确诊为MG的患者纳入分析。对于逻辑回归模型，我们进行了完整的病例分析，因此排除了发病年龄未知或胸腺瘤病史的患者。只有随访2年的患者被纳入长期结果分析。结果：在594名研究参与者中，比较了473名白人、48名非洲裔美国人（AA）、42名西班牙裔和523名非西班牙裔患者的临床特征。西班牙裔患者(平均年龄41.5±20.3岁vs 58.9±19.9岁；p < 0.001)明显比非西班牙裔患者年轻，AA患者明显比白人患者年轻(平均年龄38.6±17.1岁vs 60.7±19.4岁；P < 0.001)。AA患者接受胸腺切除术的频率更高(63.6% vs 29.5%；p < 0.001)。调整协变量后，与白人患者相比，AA患者因MG危象或恶化住院的可能性约为3倍(优势比2.77；95% ci 1.19-6.50；P = 0.018)。讨论：尽管疾病严重程度和临床特征存在差异，但患者的长期预后没有差异。我们的研究结果确定了MG护理在不同种族和民族群体中的差异，这应该由临床医生进一步解决。

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Understanding Racial and Ethnic Disparities in Myasthenia Gravis Outcomes: EXPLORE-MG Registry Experience.

Background and objectives: Past studies have reported racial and ethnic differences in patients with myasthenia gravis (MG) but either are over a decade old or only examine small samples. To better understand these differences, using the EXPLORE-MG registry, we conducted a retrospective cohort study of racial and ethnic differences in the characteristics and long-term outcomes of patients with MG.

Methods: Patients with a diagnosis of MG confirmed by one or more of the assessments such as antibody seropositivity, positive single-fiber electromyography, or decremental repetitive nerve stimulation between January 2001 and October 2023 were included in the analysis. For logistic regression models, we performed a complete case analysis, therefore excluding patients with unknown age at onset or history of thymoma. Only patients with 2 years of follow-up data were included in the long-term outcome analysis.

Results: Of 594 study participants, the clinical features of 473 White, 48 African American (AA), 42 Hispanic, and 523 non-Hispanic patients were compared. Hispanic patients (mean age 41.5 ± 20.3 years vs 58.9 ± 19.9 years; p < 0.001) were significantly younger at onset compared with non-Hispanic patients, and AA patients were significantly younger at onset compared with White patients (mean age 38.6 ± 17.1 years vs 60.7 ± 19.4 years; p < 0.001). AA patients underwent thymectomy more frequently (63.6% vs 29.5%; p < 0.001) compared with White patients. After adjusting for covariates, AA patients were approximately 3 times more likely to experience hospitalization for MG crisis or exacerbation compared with White patients (odds ratio 2.77; 95% CI 1.19-6.50; p = 0.018).

Discussion: Despite variations in disease severity and clinical profiles, long-term outcomes of patients did not differ. Our findings identify the areas of MG care that vary across racial and ethnic groups, which should be further addressed by clinicians.

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来源期刊

Neurology. Clinical practice CLINICAL NEUROLOGY-

CiteScore

4.00

自引率

0.00%

发文量

期刊介绍： Neurology® Genetics is an online open access journal publishing peer-reviewed reports in the field of neurogenetics. The journal publishes original articles in all areas of neurogenetics including rare and common genetic variations, genotype-phenotype correlations, outlier phenotypes as a result of mutations in known disease genes, and genetic variations with a putative link to diseases. Articles include studies reporting on genetic disease risk, pharmacogenomics, and results of gene-based clinical trials (viral, ASO, etc.). Genetically engineered model systems are not a primary focus of Neurology® Genetics, but studies using model systems for treatment trials, including well-powered studies reporting negative results, are welcome.