Other Diseases and Treatment Reactions Common in Myasthenia Gravis Patients, Study in India Finds

Almost 90% of patients diagnosed with myasthenia gravis develop other diseases, or comorbidities, while about 70% have treatment-related complications, a review study from India reports.

These additional disorders may contribute to a poorer outcome for these people, making early recognition and management of comorbidities essential for improving patient care and overall health-related quality of life, the researchers said.

“A study of comorbidities in myasthenia gravis” was published in the journal Acta Neurologica Belgica.

Myasthenia gravis patients are living longer lives, mainly due to greater knowledge and improved treatment. However, this has highlighted other clinical challenges, including the increasing incidence of treatment-related complications, and the development of other diseases.

Some studies have explored the impact of comorbidities on patient outcomes, but the findings have limitations and don’t provide clear data on the effects of particular conditions.

To learn more, researchers from Sanjay Gandhi Postgraduate Institute of Medical Sciences, in India, reviewed clinical records of 81 patients, ages 7 to 75.

Among these patients, 70 (86%) were positive for AchR antibodies, and four (5%) were positive for anti-Musk antibodies. More than half — 48  people, or 59% — had early onset myasthenia gravis, meaning they were 40 years old or younger at the time of diagnosis, while 33 (41%) had late-onset.

Enlargement of the thymus, a common cause of the disease, was reported in 27 patients and resolved by surgery in 19.

A majority — 71, or 88% — were found to have secondary disorders, including diabetes, hypertension, and coronary artery disease. Some had autoimmune diseases such as lupus.

Autoimmune diseases were found to be common among people with early onset disease, but the difference was not significant. In contrast, other types of comorbidities were significantly more frequent in those with late-onset myasthenia gravis.

The review also found that 54 patients (67%) developed complications — called iatrogenic complications — due to adverse effects from the medications used to treat the myasthenia gravis.

The incidence of treatment-related adverse effects, including weight gain, reduced fatty molecules levels, or osteoporotic fractures, was similar between early and late onset groups.

Further analysis showed that infections, under-or-upper-therapy dosage, surgery, and myocardial infarction (heart attacks) could trigger a myasthenia gravis acute crisis. Patients with other diseases also needed more frequent hospitalizations during a myasthenia gravis crisis than those without comorbidities, the review showed.

Patients with anti-Musk antibodies and more secondary diseases had significantly poorer outcomes than those with fewer comorbidities.

“Comorbidities in myasthenia gravis are common, and attention should be paid in managing these comorbidities with appropriate safe drugs for better outcome,” the researchers said.