Benefits of FK506 (tacrolimus) for residual, cyclosporin- and prednisone-resistant myasthenia gravis: one-year follow-up of an open-label study

Thirteen patients with myasthenia gravis, unresponsive to prednisone and cyclosporin after thymectomy, received KF506 (tacrolimus) for 12 months, at starting doses of 0.1 mg/kg per day b.i.d. and then adjusted to achieve plasma concentrations between 7 and 8 ng/mL. The doses of prednisone were progr...

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Bibliographic Details
Published in:Clinical neurology and neurosurgery 2005-04, Vol.107 (3), p.187-190
Main Authors: Ponseti, José M., Azem, Jamal, Fort, José M., Codina, Agustín, Montoro, J. Bruno, Armengol, Manuel
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Cyclosporin
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Follow-Up Studies
Glucocorticoids - administration & dosage
Humans
Immunosuppressive Agents - administration & dosage
Immunosuppressive Agents - blood
Male
Medical sciences
Middle Aged
Myasthenia gravis
Myasthenia Gravis - blood
Myasthenia Gravis - drug therapy
Neurology
Neurosurgery
Prednisolone - administration & dosage
Prednisone
Prospective Studies
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Tacrolimus
Tacrolimus - administration & dosage
Tacrolimus - blood
Treatment Outcome
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Summary:Thirteen patients with myasthenia gravis, unresponsive to prednisone and cyclosporin after thymectomy, received KF506 (tacrolimus) for 12 months, at starting doses of 0.1 mg/kg per day b.i.d. and then adjusted to achieve plasma concentrations between 7 and 8 ng/mL. The doses of prednisone were progressively reduced and finally discontinued. Anti-acetylcholine antibodies and myasthenia gravis score for disease severity decreased significantly and muscular strength increased by 37%. All patients achieved pharmacological remission, 11 were asymptomatic and two had minimal weakness of eyelid closure. Tacrolimus was well tolerated and appears a suitable approach after unsuccessful treatment with conventional immunosuppressants in patients with disabling myasthenia.
ISSN:0303-8467
1872-6968
DOI:10.1016/j.clineuro.2004.07.013