ppt myastenia gravis

7/25/2019 Ppt Myastenia Gravis

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BackgroundThe efcacy o thymectomy in patients ith

non!thymomatous Myasthenia "ra#is $M"% issti&& unc&ear'


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(bjecti#e)stimate the treatment e*ect o thymectomy

in achie#ing remission or minima&

maniestation status in patients ith non!thymomatous M"'


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Methods+ecords rom consecuti#e M" patients ho

attended the euromuscu&ar C&inic, Toronto"enera& -ospita&,

.rom /anuary 0111 to 2ugust 0134, ereretrospecti#e&y re#ieed


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MethodsThe diagnosis o M" as based on

the c&inica& presentation and

2bnorma& antibody status$acety&cho&ine ormusc&e speci5c kinase%

or sing&e 5ber e&ectromyography'


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Statistica& ana&yses6escripti#e statistics and missing data

Propensity Score $PS% Mode&s

Matching and Ba&ance o the Co#ariab&esTime!to!e#ent 2na&yses

Bayesian Mode&s


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+esu&t


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+esu&t


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+esu&t


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+esu&t.igure 0 +e&ationship beteen prednisone

treatment duration and dose o prednisoneon the &ast #isit in the matched cohort'

The o#era&& use o prednisone through timeis presented as a ratio o the time underprednisone in months, o#er the tota& o&&o!up time, to account or di*erent o&&otimes' Patients ith higher ratios oprednisone use through time ere more&ike&y to ha#e higher doses at the &ast #isit

$r 7 1'8, p 9 1'113% or both groups'There as no signi5cant di*erencebeteen groups, a&though contro&s tendedto ha#e higher doses o prednisone at the&ast #isit $p 7 ns%'


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6iscussionno#e& methods to assess the treatment e*ect

o thymectomy in non!thymomatousmyasthenia gra#is'

Bayesian ana&yses to assess the o#era&&probabi&ity o thymectomy efcacy


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6iscussionused 0 approaches to estimate prior

possibi&ities:

assuming no kno&edge $non!inormati#eprior% and

assuming e#idence o no efcacy $skeptica&prior%'


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6iscussionthymectomy is associated ith a high

probabi&ity o achie#ing remission or minima&maniestation status

thymectomy as a&so associated ith ahigher &ike&ihood o being ree rom

prednisone through time


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6iscussionPropensity scores can on&y adjust or the

knon #ariab&es,

as opposed to +CTs ere the unknon#ariab&es are assumed to be ba&anced by therandomiation


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6iscussionThe retrospecti#e data co&&ection is another

potentia& source o bias'

There is no di*erent doses prednison throughtime, hich cou&d in;uence the outcome


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Conc&usionthymectomy is associated ith a high

probabi&ity o achie#ing remission or

minima& maniestation status and o beingree rom prednisone hen compared tocontro&s


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Thank you


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0' B' Moderate genera&ied myasthenia


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B' ?ate se#ere myastheniaTimbu& pa&ing sedikit 0 tahun sete&ah ke&ompok I dan IIprogresi dari myasthenia gra#is dapat pe&an!pe&an atau

mendadak, prosentase thymoma kedua pa&ing tinggi' +esponterhadap obat dan prognosis je&ek=' Myasthenia crisisMenjadi cepat buruknya keadaan penderita myastheniagra#is dapat disebabkan :! pekerjaan 5sik yang ber&ebihan

! emosi! ineksi! progresi dari penyakitkerusakan neuro musku&er, misa&nya streptomisin, neomisisn,kurare, k&oroorm, eter, mor5n sedati#e dan musc&e re&a@an


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pato5sio&ogi


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ppt myastenia gravis

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