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BRIEF RESEARCH REPORT article

Front. Neurol.

Sec. Neuromuscular Disorders and Peripheral Neuropathies

Volume 16 - 2025 | doi: 10.3389/fneur.2025.1641701

The short-term prognosis of very late onset generalized myasthenia gravis: a single-center retrospective cohort study

Provisionally accepted
Ioannis LiampasIoannis Liampas1Dimitra VeltsistaDimitra Veltsista1,2*Dimitra VeltsistaDimitra Veltsista1,2Paraskevi BatzikostaParaskevi Batzikosta1Lefteris LazarouLefteris Lazarou1Elisabeth ChroniElisabeth Chroni1,2ZINOVIA MARIA KEFALOPOULOUZINOVIA MARIA KEFALOPOULOU1,2
  • 1Neuromuscular Center, Department of Neurology, University Hospital of Patras, Patra, Greece
  • 2University of Patras, Patras, Western Greece, Greece

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Objective: To explore the short-term prognosis of generalized very-late-onset myasthenia gravis (vloMG, symptom onset ≥65 years) in comparison with early- and late-onset MG (eloMG, <65 years). Methods: A single-center retrospective cohort study was conducted based on the medical records of patients with laboratory confirmed generalized MG, monitored in the specialized Unit of Neuromuscular Disorders of the University Hospital of Patras. Measures of clinical severity were compared at baseline and over the short term (2-year) follow-up. Results: There were 42 eligible patients (42.1±13.2 years, 50% women, 19.5±6.0 months follow-up) in the eloMG and 26 (72.4±5.0, 50% women, 13.9±7.9 months follow-up) in the vloMG group. In the vloMG group, AchR antibody positivity (89% vs. 57%, p=0.007) and oculo-bulbar symptoms at onset (88% vs. 53%, p=0.002) were more common, whereas thymus pathology (0% vs. 40%, p<0.001) and generalized weakness at onset (12% vs. 38%, p=0.018) were less frequent. Intubation within the first month from diagnosis was required only in patients with vloMG (5/26) (p=0.006). Over the follow-up: the unadjusted incidence rate ratio (IRR) of relapses was lower in the vloMG group [IRR=0.49, 95%CI=(0.26,0.92), p=0.026)], the unadjusted odds (OR) of being classified as

Keywords: prognosis, Intubation, Rescue therapy, relapse, Immunosuppressive Agents, corticosteroids

Received: 05 Jun 2025; Accepted: 25 Jul 2025.

Copyright: © 2025 Liampas, Veltsista, Veltsista, Batzikosta, Lazarou, Chroni and KEFALOPOULOU. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dimitra Veltsista, University of Patras, Patras, 25604, Western Greece, Greece

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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