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Purpose: Myasthenia gravis (MG) is a lifelong autoimmune disorder that affects neuromuscular transmission. The long-termtreatment plan should include immunotherapy. We investigated the long-term safety and efficacy of tacrolimus for the treatmentof MG in real-world clinical practice. Materials and Methods: We retrospectively reviewed 160 MG patients treated with tacrolimus from 2005 to 2015. MyastheniaGravis Foundation of America (MGFA) clinical classification, MGFA post-intervention status, myasthenic functional score, anddose of oral prednisolone were investigated. Results: Adverse events occurred in 68 patients (42.5%), most of which were minor and well-managed. Clinical severity scales improvedafter administration of tacrolimus, compared to the baseline. Compared to 6 months before administration of tacrolimus,prednisolone dose significantly decreased at 12 months after treatment (2.85±0.92 mg/day, p=0.002), 18 months after treatment(3.36±0.99 mg/day, p=0.001), and 24 months after treatment (3.71±0.93 mg/day, p<0.001). Conclusion: Tacrolimus may be effective in reducing the severity of MG and may permit a reduction in the steroid dose prescribedto the patients. Adverse events due to tacrolimus treatment were not serious.
