Patient Outcomes in Generalized Myasthenia Gravis (P02.188)

OBJECTIVE: To study clinical outcomes in patients with generalized myasthenia gravis (MG) treated with and without thymectomy. BACKGROUND: Thymectomy is widely recognized as a therapeutic option in patients with non-thymomatous generalized MG despite lack of randomized, controlled trial evidence. Based on retrospective cohorts, younger patients are considered the best candidates for surgery and, in our center, thymectomy is offered to MG patients who are DESIGN/METHODS: 173 patients with confirmed, non-thymomatous, generalized MG, and at least 6 months of follow-up were included. Demographic data and medical treatments were compared for both groups. The primary outcome was the proportion of patients in remission or having minimal manifestations (MM) at the last visit, as defined by the MGFA. Survival analyses were done to study the time to remission or MM in both groups. RESULTS: 68 (39%) patients had a thymectomy. The mean follow-up time was 36±27 months (range:6-114). Thymectomized patients were younger (37±13 vs. 66±12 years, p CONCLUSIONS: Patients without thymectomy had similar medical management as the thymectomized patients. The observation that older, non-thymectomized patients had similar outcomes to younger, thymectomized ones supports the current practice of age restriction for thymectomy. Further studies are required to determine the overall efficacy of thymectomy in comparable populations. Disclosure: Dr. Barnett Tapia has nothing to disclose. Dr. Katzberg has received personal compensatino for activities with Genzyme as a speaker and medical advisor. Dr. Bril has received personal compensation from Talecris Biotherapeutics for consulting services. Dr. Bril has received research support from Talecris Biotherapeutics.