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Abstract Details

Survival Outcomes of Medicare-covered Elderly US Population with Myasthenia Gravis
Neuromuscular and Clinical Neurophysiology (EMG)
P6 - Poster Session 6 (11:45 AM-12:45 PM)
11-032
We performed a retrospective longitudinal study using Medicare claims data (2006 - 2019). 
Survival outcomes and causes of death have been inadequately studied among myasthenia gravis (MG) patients in the United States (US).
Incident MG cohort in 2010-2011 was identified; age ≥65 years, at least one month of FFS Parts A/B coverage, no health maintenance organization insurance coverage, initial and subsequent MG claims within 2010-2011 separated by at least 28 days. The non-MG control cohort was randomly selected 5 times the number of the MG cohort matched with age, sex, region of residence, and start of Medicare coverage. Overall and cause-specific mortality was compared between cohorts in the following 7-year period using the Kaplan-Meier plots and Cox proportional hazard model, adjusted for the Charlson comorbidity index (CCI). Mortality rates were estimated with Poisson regression offset by total enrollment (person-year).
Cohorts of 6,024 incident MG and 30,083 control beneficiaries were identified. Baseline demographics were well-matched between cohorts. Average 7-year mortality rate was higher in the MG cohort compared to the control cohort (66.8 vs 57.1 per 1,000-person-year, p<0.0001). 6% of the MG cohort died of MG as the primary cause. Compared to the non-MG control cohort, mortality rates (per 1,000-person-year) specific to MG and infection as the cause of death were significantly higher among the MG cohort (<0.01 vs 11.0 and 1.2 vs 2.0 respectively) while malignancies and dementia-specific mortality rates were significantly lower in the MG cohort (12.5 vs 10.3 and 7.2 vs 4.7). The CCI was higher in the MG cohort at enrollment and during the follow-up periods. After adjusting for the time-varying CCI, there was no significant difference in 7-year survival between the MG and the control cohorts. 
Long-term mortality is slightly increased in elderly MG patients compared to non-MG counterparts, driven by MG-related deaths and their higher comorbidities. 
Authors/Disclosures
Ikjae Lee, MD (Columbia University)
PRESENTER 		Dr. Lee has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Regeneron. The institution of Dr. Lee has received research support from NIH. The institution of Dr. Lee has received research support from Spastic Paraplegia Foundation.
Yuebing Li, MD, PhD, FAAN (Cleveland Clinic) Dr. Li has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Argenx. Dr. Li has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Amgen. Dr. Li has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Vertex. The institution of Dr. Li has received research support from Argenx.
David Bruckman, MS Mr. Bruckman has nothing to disclose.
Jesse Schold (University of Colorado) No disclosure on file
Benjamin R. Claytor, MD (Cleveland Clinic) Dr. Claytor has nothing to disclose.
Nicholas J. Silvestri, MD, FAAN (UBMD Neurology) Dr. Silvestri 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. Silvestri has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Regeneron. Dr. Silvestri 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. Silvestri 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. Silvestri 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. Silvestri 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. Silvestri has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for argenx. Dr. Silvestri has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. The institution of an immediate family member of Dr. Silvestri has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for UCB. Dr. Silvestri has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Takeda. Dr. Silvestri has received publishing royalties from a publication relating to health care.
Michael K. Hehir II, MD (Larner College of Medicine at the University of Vermont) Dr. Hehir has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Argenx. Dr. Hehir has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Alexion. Dr. Hehir has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for UCB Pharma. Dr. Hehir has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Janssen. Dr. Hehir has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Immunovant. Dr. Hehir has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Continuum- 好色先生. Dr. Hehir has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for MedLink Neurology. The institution of Dr. Hehir has received research support from Myasthenia Gravis Foundation of America. The institution of Dr. Hehir has received research support from University of Vermont Medical Center.