Abstract Details

Title Characteristics of Cohort with Generalized Myasthenia Gravis in PREDICT Study

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) P6 - Poster Session 6 (11:45 AM-12:45 PM)

Poster/Presentation
Number 11-029

Objective To characterize a longitudinal cohort of patients with generalized myasthenia gravis.

Background Generalized myasthenia gravis (gMG) is an autoimmune neuromuscular disorder of widely varying clinical severity. The PREDICT study seeks to identify a contemporary cohort of patients with gMG and discover predictors of disease severity.

Design/Methods Clinical data extracted from a hospital system (consisting of 12 academic and community hospitals) between 2010-2023. Adults diagnosed with gMG confirmed by neurology with minimum follow-up of one year were included. Demographics, treatment history, and hospitalization history were analyzed.

Results 406 patients met inclusion criteria with mean follow-up of 7.1 years (SD 6.2). The median age at symptom onset was 64 years (IQR 16, 93) with 40.6% female, 59.4% male; 88.9% White, 4.2% African American, 2.5% Asian. 71.4% with gMG tested positive for acetylcholine receptor antibody with only 5 patients with gMG testing positive for MuSK. At diagnosis, 30 (7.4%) had comorbid autoimmune condition with multiple sclerosis being most common. Median age at MG symptom onset was 60 years (IQR 17, 93) in females compared to 65 years (IQR 16, 92) in males. 34.5% presented initially with ocular MG. 98.3% were treated with non-corticosteroid MG directed therapy of which pyridostigmine was used in 382 (95.7%) followed by azathioprine in 153 (38.3%), mycophenolate mofetil in 145 (36.3%), immunoglobulin injections in 105 (26.9%), rituximab in 27 (6.8%), maintenance plasma exchange in 27 (6.8%), complement inhibitors in 17 (4.3%), and efgartigimod in 11 (2.8%). During follow-up, 139 (34.2%) had a gMG related hospitalization.

Conclusions Myasthenia gravis is a disease of older adults with earlier onset by 5 years in females compared to males and with about a third of patients needing hospitalization. Azathioprine and mycophenolate mofetil remain the most used steroid sparing immunomodulatory treatments. Follow up to include additional data on gMG related hospitalization.

Authors/Disclosures
Shamik Bhattacharyya, MD, FAAN (Brigham and Women's Hospital) PRESENTER	Dr. Bhattacharyya has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NeuroLambda. Dr. Bhattacharyya has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion Pharmaceuticals. Dr. Bhattacharyya has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Dr. Bhattacharyya has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Bhattacharyya has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Continuum. Dr. Bhattacharyya has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wiley. Dr. Bhattacharyya has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Merck. The institution of Dr. Bhattacharyya has received research support from Alexion Pharmaceuticals. The institution of Dr. Bhattacharyya has received research support from National Institute of Health. The institution of Dr. Bhattacharyya has received research support from UCB. The institution of Dr. Bhattacharyya has received research support from Genentech. Dr. Bhattacharyya has received publishing royalties from a publication relating to health care. Dr. Bhattacharyya has received publishing royalties from a publication relating to health care.
Sathya S. Narasimhan, MBBS (Baylor College of Medicine)	Dr. Narasimhan has nothing to disclose.
Danielle Kei Pua, MD (Westchester Medical Center)	Dr. Pua has nothing to disclose.
Yihan Zhang (Brigham and Women's Hospital, Harvard Medical School)	No disclosure on file
Prashanth Rajarajan, MD, PhD (Brigham and Women's Hospital)	Dr. Rajarajan has nothing to disclose.
Mattia Wruble, MD	The institution of Dr. Wruble has received research support from Alexion. The institution of Dr. Wruble has received research support from Roche.
James V. Nguyen, MD, MEd (Mass General Brigham)	Dr. Nguyen has nothing to disclose.
Alice Tang, MBBS	Dr. Tang has received personal compensation for serving as an employee of Third Rock Ventures.
Chien-Lin Su (Worldwide Clinical Trials)	No disclosure on file
Michael Blackowicz, PhD (Alexion)	Dr. Blackowicz has received personal compensation for serving as an employee of Alexion Pharmaceuticals. Dr. Blackowicz has stock in Alexion Pharmaceuticals.
Chloe S. Sader, PharmD (Alexion)	Chloe Sader has received personal compensation for serving as an employee of Alexion. Chloe Sader has received stock or an ownership interest from Alexion.
Joome Suh, MD (Brigham and Women's Hospital)	Dr. Suh 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. Suh has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for argenx.

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