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Abstract Details

Long-term risk of generalization in patients with pure ocular myasthenia gravis
Neuromuscular and Clinical Neurophysiology (EMG)
P3 - Poster Session 3 (12:00 PM-1:00 PM)
1-009
To study the risk of generalization in patients with pure ocular MG, and specifically to assess if early treatment with steroids reduces the risk of generalized disease.
Ocular symptoms are often the presenting manifestations in myasthenia gravis (MG), and approximately 20% of patients have pure ocular MG. The reported risk of generalization ranges between 30 to 60%. Factors associated with increased risk of generalization include other autoimmune disease, late age of onset (> 40 years), thymus hyperplasia, and seropositive status.  Early treatment with steroids may also affect rates of generalization.
We performed a retrospective chart review of patients with confirmed ocular MG, attending a tertiary center between 2015-2019.We included data on antibody status, age, sex, treatments, progression to generalized disease and symptom severity at the last visit. We used a Cox-proportional hazard model to assess factors associated with generalization. We will also build propensity score models to assess the effect of steroidal treatment on generalization.
162 patients were included in this cohort. Mean age at onset was 57±16 years, and 78 (48%) were female. Mean follow up was 5.0±4.6 years. At the last visit, 48 (30%) of patients had generalized; mean time to generalization was 28.8 ± 41 months. The proportion of patients treated with prednisone was similar in patients who generalized vs. those who did not (65% and 61%, respectively, p=ns). The Cox model showed that age at onset was the only factor associated with generalization (HR: 3.28, CI:1.43-7.5).

In a preliminary analysis, only older age at onset was associated with generalization; other factors did not appear to influence spread of disease. Results of the propensity score models assessing the effect of prednisone  will be presented.
Authors/Disclosures
Mohammed S. Alharbi, MD
PRESENTER 		No disclosure on file
No disclosure on file
Mohammed Alqwaifly, MBBS (Unaizah College of Medicine, Qassim University) No disclosure on file
Hans D. Katzberg, MD, FAAN An immediate family member of Dr. Katzberg has received personal compensation for serving as an employee of Alexion. Dr. Katzberg has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Argenx. Dr. Katzberg has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for UCB. Dr. Katzberg has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Katzberg has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Dyne. Dr. Katzberg has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merz. Dr. Katzberg has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for CSL Behring. Dr. Katzberg has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Johnson and Johnson. Dr. Katzberg has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. Dr. Katzberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Syneos Health. Dr. Katzberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Katzberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ArgenX.
Vera Bril, MD (Toronto General Hospital) Dr. Bril has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB. Dr. Bril has received personal compensation in the range of $500-$4,999 for serving as a Consultant for CSL. Dr. Bril has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alnylam. Dr. Bril has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Dr. Bril has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Grifols. Dr. Bril has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Takeda. Dr. Bril has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Octapharma. Dr. Bril has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pfizer. Dr. Bril has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Powell Mansfield. Dr. Bril has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Akcea. Dr. Bril has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ionis. Dr. Bril has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Immunovant. Dr. Bril has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi. Dr. Bril has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Bril has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Momenta (now J&J). Dr. Bril has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Bril has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NovoNordisk. Dr. Bril has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Takeda. Dr. Bril has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Immunovant. Dr. Bril has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Bril has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Akcea. Dr. Bril has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Bril has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alnylam. Dr. Bril has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for CSL. Dr. Bril has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Argenx. The institution of Dr. Bril has received research support from UCB. The institution of Dr. Bril has received research support from Argenx. The institution of Dr. Bril has received research support from Momenta (now J&J). The institution of Dr. Bril has received research support from Immunovant. The institution of Dr. Bril has received research support from Alexion. The institution of Dr. Bril has received research support from Takeda. The institution of Dr. Bril has received research support from Grifols. The institution of Dr. Bril has received research support from CSL. The institution of Dr. Bril has received research support from Octapharma. The institution of Dr. Bril has received research support from Akcea. The institution of Dr. Bril has received research support from Ionis. The institution of Dr. Bril has received research support from Viela Bio (now Horizon). Dr. Bril has received intellectual property interests from a discovery or technology relating to health care.
Carolina Barnett Tapia, MD Dr. Barnett Tapia has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Argenx. Dr. Barnett Tapia has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Dr. Barnett Tapia has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for UCB. Dr. Barnett Tapia has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Barnett Tapia has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NMD pharma. Dr. Barnett Tapia has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Barnett Tapia has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for argenx. Dr. Barnett Tapia has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen. Dr. Barnett Tapia has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. Dr. Barnett Tapia has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for argenx. The institution of Dr. Barnett Tapia has received research support from Department of defense. The institution of Dr. Barnett Tapia has received research support from Muscular dystrophy canada. The institution of Dr. Barnett Tapia has received research support from MgNet. The institution of Dr. Barnett Tapia has received research support from NIH. The institution of Dr. Barnett Tapia has received research support from Cartesian. The institution of Dr. Barnett Tapia has received research support from Alexion. Dr. Barnett Tapia has received intellectual property interests from a discovery or technology relating to health care.