[Pubmed] Prognosis After Discontinuation of Azathioprine or Mycophenolate Mofetil in Well-Controlled Myasthenia Gravis:

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Muscle Nerve. 2025 Dec 12. doi: 10.1002/mus.70105. Online ahead of print.

ABSTRACT

INTRODUCTION/AIMS: Azathioprine (AZA) and mycophenolate mofetil (MMF) are generally used for long periods when treating myasthenia gravis. In well-controlled patients, discontinuation of AZA/MMF may be a cause for concern because of the possibility of relapse. We aimed to evaluate relapse and relapse-related parameters after discontinuation of AZA/MMF.

METHOD: Patients who had discontinued AZA or MMF monotherapy were retrospectively reviewed. We reviewed relapse, whether in pharmacological remission (PR) or exhibiting minimal manifestations (MM 1), disease duration, duration of AZA/MMF use, and other clinical parameters.

RESULTS: A total of 32 patients were included who either discontinued AZA (n = 28) or MMF (n = 4) treatments. Relapse was detected in 11 (34%). Patients in PR had fewer relapses than those with MM 1 (p = 0.023). Intravenous immunoglobulin was required in four. All patients who relapsed were stabilized with AZA/MMF. No significant association was found between relapse and age of disease onset, duration of disease, duration of AZA/MMF use, thymectomy status, or maximum Myasthenia Gravis Foundation of America score during active disease.

DISCUSSION: The results of this study suggest that patients in PR are less likely to relapse compared to those in MM 1. In well-controlled MG patients, AZA/MMF may be discontinued.

PMID:41388640 | DOI:10.1002/mus.70105


Source: https://pubmed.ncbi.nlm.nih.gov/4138864 ... 22+67771e2