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Background <p>Myasthenia gravis is a rare disease characterized by autoantibody-driven impairment of neuromuscular junction activity. Standard-of-care therapy includes oral corticosteroids (OCS), despite associated complications. This study describes OCS-related complications and exacerbations in a real-world myasthenia gravis population.</p> Methods <p>This retrospective longitudinal cohort study leveraged US claims data (January 2016–March 2023; Optum’s de-identified Clinformatics<sup>®</sup> Data Mart Database) to identify patients with myasthenia gravis (<i>International Classification of Diseases, Tenth Revision, Clinical Modification</i>: G70.00/01). Patients were classified into non-OCS and OCS cohorts; the OCS cohort was further stratified into &lt; 6-month, 6-month, and 12-month exposure groups (≥ 5 mg/day prednisone-equivalent; 12-month follow-up). Inverse probability treatment weighting balanced baseline characteristics. Weighted prevalence ratios of select complications (e.g., diabetes, fracture, hyperlipidemia, hypertension, infection, myocardial infarction, osteoporosis, stroke, glaucoma) and rate/risk ratios for exacerbations were calculated.</p> Results <p>The weighted population included 3297 patients in the non-OCS cohort and 418, 872, and 1243 patients in the &lt; &#xa0;6-month, 6-month, and 12-month OCS exposure groups, respectively. During follow-up, the &lt; &#xa0;6-month, 6-month, and 12-month OCS exposure groups had significantly higher infection risk versus non-OCS: weighted prevalence ratios (95% confidence interval) 1.6 (1.1–2.1), 1.5 (1.2–2.0), and 1.6 (1.3–2.0), respectively. Osteoporosis risk was similar in the &lt; &#xa0;6-month group but higher in the 6- and 12-month groups versus non-OCS: weighted prevalence ratios (95% confidence interval) 1.2 (0.9–1.6), 1.5 (1.2–1.8), and 1.7 (1.4–2.0), respectively. Oral corticosteroid exposure groups had more myasthenia gravis exacerbations during follow-up versus non-OCS.</p> Conclusions <p>After adjusting for observable confounders, OCS exposure within the 12-month initiation period was associated with a higher burden of complications and exacerbations among patients with myasthenia gravis.</p> Graphical Abstract <p></p>

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Complications and Occurrence of Exacerbations in Patients with Myasthenia Gravis Treated with Oral Corticosteroids

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月8日

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  • Zhiwen Liu,
  • Louis Jackson,
  • Jacqueline Pesa,
  • Alicia K. Campbell,
  • Zia Choudhry,
  • Nizar Souayah

摘要

Background

Myasthenia gravis is a rare disease characterized by autoantibody-driven impairment of neuromuscular junction activity. Standard-of-care therapy includes oral corticosteroids (OCS), despite associated complications. This study describes OCS-related complications and exacerbations in a real-world myasthenia gravis population.

Methods

This retrospective longitudinal cohort study leveraged US claims data (January 2016–March 2023; Optum’s de-identified Clinformatics® Data Mart Database) to identify patients with myasthenia gravis (International Classification of Diseases, Tenth Revision, Clinical Modification: G70.00/01). Patients were classified into non-OCS and OCS cohorts; the OCS cohort was further stratified into < 6-month, 6-month, and 12-month exposure groups (≥ 5 mg/day prednisone-equivalent; 12-month follow-up). Inverse probability treatment weighting balanced baseline characteristics. Weighted prevalence ratios of select complications (e.g., diabetes, fracture, hyperlipidemia, hypertension, infection, myocardial infarction, osteoporosis, stroke, glaucoma) and rate/risk ratios for exacerbations were calculated.

Results

The weighted population included 3297 patients in the non-OCS cohort and 418, 872, and 1243 patients in the <  6-month, 6-month, and 12-month OCS exposure groups, respectively. During follow-up, the <  6-month, 6-month, and 12-month OCS exposure groups had significantly higher infection risk versus non-OCS: weighted prevalence ratios (95% confidence interval) 1.6 (1.1–2.1), 1.5 (1.2–2.0), and 1.6 (1.3–2.0), respectively. Osteoporosis risk was similar in the <  6-month group but higher in the 6- and 12-month groups versus non-OCS: weighted prevalence ratios (95% confidence interval) 1.2 (0.9–1.6), 1.5 (1.2–1.8), and 1.7 (1.4–2.0), respectively. Oral corticosteroid exposure groups had more myasthenia gravis exacerbations during follow-up versus non-OCS.

Conclusions

After adjusting for observable confounders, OCS exposure within the 12-month initiation period was associated with a higher burden of complications and exacerbations among patients with myasthenia gravis.

Graphical Abstract