Abstract
We evaluated cyclosporine A (CsA) treatment in 9 patients (6 female and 3 male), 16–63 years old, with severe myasthenia gravis (MG) for a mean period of 2 years (range 16–36 months). All of the patients had been previously treated either with corticosteroids or by combined immunotherapy, and 5 needed periodic plasma exchanges. The reduction of plasmapheresis cycles in the 5 patients who needed periodic plasma exchange to mantain an acceptable quality of life showed an impressive cost-benefit analysis. During CsA treatment 7 of 9 patients improved their muscle strength and functional score. In all the patients except one the corticosteroid dosage was reduced and in 7 of the 9 patients the dose reduction was over 50% with subsequent reduction of the corticosteroid side effects. The findings showed that initiation of CsA treatment increased muscle strength and reduced corticosteroid dosage. The most common CsA side effects were: a serum creatinine increase that occurred in the first 6– 12 months of therapy in 8 patients, other side effects like hypertrichosis and gingival hyperplasia were present in four patients. Blood pressure increase was found in only one patient. CsA treatment may be a valuable and cost effective treatment in severe MG.
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Received: 23 September 1996 Received in revised form: 6 April 1997 Accepted: 26 May 1997
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Bonifati, D., Angelini, C. Long-term cyclosporine treatment in a group of severe myasthenia gravis patients. J Neurol 244, 542–547 (1997). https://doi.org/10.1007/s004150050141
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DOI: https://doi.org/10.1007/s004150050141