Efficacy of high-dose intravenous methylprednisolone therapy for ocular myasthenia gravis

• Published in: Journal of the neurological sciences 2019-07, Vol.402, p.12-15
• Main Authors: Ozawa, Yukiko, Uzawa, Akiyuki, Kanai, Tetsuya, Oda, Fumiko, Yasuda, Manato, Kawaguchi, Naoki, Himuro, Keiichi, Kuwabara, Satoshi
• Format: Article
• Language: English
• Subjects: Efficacy; Intravenous methylprednisolone; Ocular myasthenia gravis; Prednisolone; Safety
• ISSN: 0022-510X; 1878-5883
• DOI: 10.1016/j.jns.2019.05.003

High-dose intravenous methylprednisolone (IVMP) is often used as a treatment for generalized myasthenia gravis (MG); however, little is reported about the efficacy of IVMP in ocular MG. We evaluated the efficacy and safety of IVMP therapy and compared results with those of conventional oral prednisolone (PSL) treatment in ocular MG. We retrospectively studied 18 patients with ocular MG. Clinical course and safety during 6 months in 10 patients who were treated with IVMP were compared with those of 8 who were treated with PSL. IVMP (1000 mg/day) was administered one to three times within 6 months, whereas oral PSL was administered at the dose of 5–10 mg/day. The score for MG activities of daily living profile (MGADL) was assessed at baseline and at 1, 3, and 6 months after treatment. Patients who received IVMP showed faster improvements than those receiving PSL; the median changes in the ocular scores on the MGADL was −2 versus 0 at 1 month (p = 0.03), −3 versus −1 at 3 months (p = 0.07), and −3 versus −2 (p = 0.86) at 6 months. No patient in either group developed initial worsening of symptoms or generalized weakness. In conclusion, IVMP results in more rapid improvement than oral PSL therapy and can be a treatment option for ocular MG. •We compared the efficacy of IVMP with that of conventional PSLin the treatment of ocular MG.•Adverse effects of IVMP treatment were similar with those of oral PSL.•Notably, IVMP resulted in more rapid improvement than oral PSL therapy.