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

Abstract

IntroductionThe 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.MethodsThis 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.ResultsA 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.ConclusionThis 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.