Clinical efficacy and safety of intravenous immunoglobulin combined with glucocorticoid in the treatment of myasthenia gravis in elderly patients

Objective To investigate the effectiveness and safety of intravenous immunoglobulin combined with oral glucocorticoid in the treatment of myasthenia gravis in elderly patients. Methods A total of 235 elderly patients diagnosed as myasthenia gravis in our hospital were enrolled in our study from January 2012 to December 2016, and randomly divided into observation group (intravenous immunoglobulin combined with oral glucocorticoid n=118) and control group (oral glucocorticoid only, n=117). The clinical curative effect, immune function index, QMG scale, symptom remission time, length of hospitalization, and adverse reactions in both groups were recorded and analyzed after two-week treatment. Results The total effective rate was significantly higher in observation group (106/117, 90.6%) than in control group (84/118, 71.2%) (χ2=5.621, P=0.000). The levels of serum IgG1, IgG3, and complement C3 were significantly higher in observation group than in control group (P<0.05). The QMG scale, symptom remission time, and length of hospitalization were lower in observation group [(9.2±4.0) score, (6.2±1.6) d, (14.4±3.3) d] than in the control group [(13.4±6.1) score, (11.6±2.4) d, (25.1±4.8) d] (t=6.158, 19.797, and 20.078, P=0.000, 0.002 and 0.009). No serious adverse reaction was observed in both groups. Conclusions The combined therapies of intravenous immunoglobulin and oral glucocorticoid for myasthenia gravis in the elderly have remarkable effectiveness.It is close to an ideal treatment because it effectively inhibits a disease progression in time, regulates an immune function, and shortens a hospitalization time. Key words: Immunoglobulins; Glucocorticoids; Myasthenia gravis; Intravenous injection