Cyclosporine in the treatment of myasthenia gravis.
Lavrnic D, Vujic A, Rakocevic-Stojanovic V, Stevic Z, Basta I, Pavlovic S, Trikic R, Apostolski S.
Institute of Neurology, Clinical Center of Serbia, Belgrade, Serbia and Montenegro.
Cyclosporine A (CsA) treatment was evaluated in 52 patients with severe generalized myasthenia gravis (MG) whose illness was not controlled by anticholinesterase drugs, thymectomy, corticosteroids, and azathioprine. The efficacy of CsA treatment was expressed by mean disability score quotient (MDSQ), which was obtained by comparing mean disability score (MDS) at the beginning of the treatment with the MDS at the end of the follow-up period. For the entire group of patients MDSQ was 53.3%, indicating moderate improvement. Analyzing individual cases, eight patients (15%) did not improve, 17 (33%) showed moderate improvement, 20 (38%) showed remarkable improvement, and seven patients (14%) achieved complete remission. The most common side effects were rise of serum creatinine (seven), hypertension (two), gingival hyperplasia (two), hypertrichosis (six), myalgia (10), and 'flu-like' symptoms (10 patients). The results of this study suggest that CsA is efficacious and safe treatment in severe and resistant forms of MG.
环孢霉素治疗重症肌无力
Lavrnic等应用环孢霉素治疗52例经胆碱酯酶抑制剂、胸腺切除、激素、硫唑嘌呤等治疗效果不佳的全身型重症肌无力病人，疗效评价采用平均残障评分系数(MDSQ)来表示，MDSQ通过治疗前的平均残障评分与治疗结束时的评分相比而得。MG病人组的MDSQ为53.3%，提示病情有中度改善。具体分析病例发现8例（15%）病人没有改善，17例（33%）有中度改善，20例（38%）有明显改善，7例（14%）达到完全缓解。最常见的副反应为血清CK增高（7例）、高血压（2例）、牙龈增生（2例）、多毛（6例）、肌痛（10例）、流感样症状（10例）。本研究表明环孢霉素对于严重难治性MG是安全有效的。
