Abstract Details

Title Risk of Infection in Patients with Myasthenia Gravis With and Without Thymoma

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 10-008

Objective To assess the risk of infection in patients with myasthenia gravis (MG) with thymoma compared to MG patients without thymoma.

Background MG is treated with multiple immunosuppressive agents and is sometimes associated with thymoma, which may increase the risk of infection further. Understanding infection risk may help with degree of immunosuppression and attempts to prevent infection with prophylactic vaccination/antibiotic treatments.

Design/Methods Retrospective analysis of all adult patients with AChR+ve MG at our center from 2015 to 2022 was performed. Rates of herpes zoster, pneumonia, UTI, meningitis, pneumocystis jirovecii pneumonia, sepsis, CMV infections, and morbidity were analyzed in MG patients with or without a history of thymoma. We used descriptive statistics and propensity score (PS) matching for comparative analysis. Infections within 6 months of chemotherapy were excluded.

Results We identified 141 patients diagnosed with AChR+ve MG, 30 with thymoma, and 111 without thymoma. The thymoma group had a higher percentage of females and patients of Asian descent, but similar ages. Comorbidity scores were similar, but the thymoma group had higher rates of chronic pulmonary disease. Baseline measures were notable for more neurologic diagnoses and higher immunosuppressant use in the thymoma group. The unadjusted rates of all infections during the follow up period were 37% in the thymoma group and 11.7% in the non-thymoma group; this was significant in the unmatched and basic-matched analyses (OR 16.1, 95% CI: 2.04 to 744, p = 0.002) but not after PS-matched analysis (OR 1.75, 95% CI: 0.52-5.87, p=0.36). Rates of pneumonia and sepsis were significantly higher in the thymoma group in unmatched, but not in the PS-matched, analysis. Rates of CMV, Zoster, UTI, and death were similar.

Conclusions The rates of all non-chemotherapy related infections in patients with MG and thymoma are higher compared to MG patients without thymoma but are similar after adjusting for comorbidities and observable confounders.

Authors/Disclosures
Katherine M. Clifford, MD PRESENTER	Dr. Clifford has nothing to disclose.
Will McKeen, MD	Dr. McKeen has nothing to disclose.
	No disclosure on file
Srikanth Muppidi, MD, FAAN	Dr. Muppidi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion. Dr. Muppidi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for argenx. Dr. Muppidi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for UCB/Ra Pharma. Dr. Muppidi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Horizont Pharma. Dr. Muppidi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for J & J pharma. Dr. Muppidi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Dianthus Pharma. Dr. Muppidi has received publishing royalties from a publication relating to health care.

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