MYASTHENIA: CURRENT TREATMENT STRATEGIES


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Abstract

Myasthenia is a severe disease that results from an antibody-mediated autoimmune disorder of neuromuscular synaptic transmission. The high prevalence of the disease, the severity of its clinical manifestations, and the instability of the patients’ status even during therapy determine the urgency to elaborate optimal therapeutic strategies for the management of these patients. The paper presents current approaches to treating myasthenia, describes in detail drug treatment options and the possibility of surgical intervention, and gives data on the use of ozone therapy for this disease.

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About the authors

O. Lapshina

Nizhny Novgorod State Medical Academy

Email: olga-med@list.ru

K. Komshina

Nizhny Novgorod State Medical Academy

E. Antipenko

Nizhny Novgorod State Medical Academy

MD

A. Gustov

Nizhny Novgorod State Medical Academy

Professor MD

References

  1. Санадзе А.Г. Миастения и миастенические синдромы / М.: ЛитТерра, 2012; 255 с.
  2. Гусев Е.И., Коновалов А.Н., Скворцова В.И. Неврология: Национальное руководство / М.: ГЭОТАР-Медиа, 2015; 1064 с.
  3. Mehndiratta M., Pandey S., Kuntzer T. Acetylcholinesterase inhibitor treatment for myasthenia gravis // Cochrane Database Syst. Rev. - 2011; CD006986.
  4. Skeie G., Apostolski S., Evoli A. et al. Guidelines for treatment of autoimmune neuromuscular transmission disorders // Eur. J. Neurol. - 2010; 17: 893-902.
  5. Kupersmith M. Ocular myasthenia gravis: treatment successes and failures in patients with long-term follow-up // J. Neurol. - 2009; 256: 1314-20.
  6. Sommer N., Sigg B., Melms A. et al. Ocular myasthenia gravis:response to long-term immunosuppressive treatment // J. Neurol. Neurosurg. Psychiatry. -1997; 62: 156-62.
  7. Bae J., Go S., Kim B. Clinical predictors of steroidinduced exacerbation in myasthenia gravis // J. Clin. Neurosci. - 2006; 13: 1006-10.
  8. Arsura E., Brunner N., Namba T. et al. High-dose intravenous methylprednisolone in myasthenia gravis // Arch. Neurol. - 1985; 42: 1149-53.
  9. Mantegazza R., Antozzi C., Peluchetti D. et al. Azathioprine as a single drug or in combination with steroids in the treatment of myasthenia gravis // J. Neurol. - 1988; 235: 449-53.
  10. Tindall R., Phillips J., Rollins J. et al. A clinical therapeutic trial of cyclosporine in myasthenia gravis // Ann. NY Acad. Sci. 1993; 681: 539-51.
  11. Heckmann J., Rawoot A., Bateman K. et al. A single-blinded trial of methotrexate versus azathioprine as steroid-sparing agents in generalized myasthenia gravis // BMC Neurol. 2011; 11: 97.
  12. Ciafaloni E., Massey J., Tucker-Lipscomb B. et al. Mycophenolate mofetil for myasthenia gravis: an openlabel pilot study // Neurology. - 2001; 56: 97-9.
  13. Hehir M., Burns T., Alpers J. et al. Mycophenolate mofetil in achr-antibody-positive myasthenia gravis: outcomes in 102 patients // Muscle Nerve. - 2010; 41: 593-8.
  14. Evoli A., Di Schino C., Marsili F. et al. Successful treatment of myasthenia gravis with tacrolimus // Muscle Nerve. - 2002; 25: 111-4.
  15. Drachman D., Adams R., Hu R. et al. Rebooting the immune system with high-dose cyclophosphamide for treatment of refractory myasthenia gravis // Ann. NY Acad. Sci. - 2008; 1132: 305-14.
  16. Gelfand E. Intravenous immune globulin in autoimmune and inflammatory diseases // N. Engl. J. Med. - 2012; 367: 2015-25.
  17. Gajdos P., Tranchant C., Clair B. et al. Treatment of myasthenia gravis exacerbation with intravenous immunoglobulin: a randomized double-blind clinical trial // Arch. Neurol. - 2005; 62: 1689-93.
  18. Schroder A., Linker R., Gold R. Plasmapheresis for neurological disorders // Expert Rev. Neurother. - 2009; 9: 1331-9.
  19. Gronseth G., Barohn R. Practice parameter: thymectomy for autoimmune myasthenia gravis (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology // Neurology. - 2000; 55: 7-15.
  20. Седышев Д.В., Руин В.А., Никитенко А.И. Особенности восстановительного лечения больных миастенией с тимомой // Медикум. - 2003; 3: 46-8.
  21. Густов А.В., Конторщикова К.Н., Потехина Ю.П. Озонотерапия в неврологии. Монография / М.: НижГМА, 2012; 192 с.
  22. Дрозд О.А., Ефремов В.В., Дударев И.В. Эффективность озонотерапии и цитофлавина в комплексном лечении миастении // Журн. неврол. и психиат. - 2013; 1: 46-9.
  23. Лапшина О.В., Антипенко Е.А., Конторщикова К.Н. и др. Влияние озонотерапии на окислительный гомеостаз пациентов с миастенией // Практ. медицина. - 2017; 1: 110-3.

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