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Abstract Details

Mortality in Mechanically Ventilated Myasthenia Gravis Adult Patients: Comparing Intravenous Immunoglobulin vs Steroids
Autoimmune Neurology
P1 - Poster Session 1 (8:00 AM-9:00 AM)

Steroids and IVIg are both used in the treatment of patients with severe myasthenia gravis.

To investigate whether there is a significant difference in mortality in adult patients with severe myasthenia gravis, determined by use of a mechanical ventilator,  between intravenous immunoglobulin (IVIg) and steroids.

The New York State Planning and Research Cooperation (SPARCS) database was utilized to collect all adult patients with myasthenia gravis (MG) who were mechanically ventilated. Patient’s age was restricted to 18 or older. Patients taking both IVIg and Steroids were excluded from analysis.

 1,730 patients with MG on mechanical ventilators were collected for analysis. 595 patients died. 63 patients received steroid treatment and 19 of these patients died (30.1%). 154 myasthenia gravis patients received IVIg treatment and 30 of them died (19.4%). There was no significant difference in average age between the two groups (77.13±14.54 vs 72.58±10.34; p=0.241) or gender (p=0.136). There was no significant difference in proportion who received IVIg versus steroid (p=0.116). Multivariate regression analysis performed on all patients demonstrated that the likelihood of death is not significantly different between the use of steroids compared to patients not treated with steroids or IVIg (OR: 1.023; 95% CL: 0.578-1.812; p=0.937). However, the likelihood of death was significantly reduced in the group treated with IVIg compared to the patients who did not receive IVIg or steroids (OR: 0.510; 95% CL: 0.332-0.782; p=0.002).

IVIg was associated with a decreased likelihood of mortality in patients with severe myasthenia gravis when compared to steroids. Limitations of this analysis include differential treatment algorithms for IVIg and steroids, and different situations for their use. Work is ongoing to calculate the likelihood confounding for comorbid conditions, with subgroup analysis and increasing length of time for study period. 

Kranthi Kiran Mandava
Mr. Mandava has nothing to disclose.
Kazim Jaffry Mr. Jaffry has nothing to disclose.
Mustafa Jaffry Mr. Jaffry has nothing to disclose.
Anam Khalid Shaikh (New Jersey Medical School) Miss Shaikh has nothing to disclose.
Ronak Uday Trivedi Mr. Trivedi has nothing to disclose.
Muhammed Ors Mr. Ors has nothing to disclose.
Iqra *Use 379943 Faiz, Masters student Ms. Faiz has nothing to disclose.
Reza Mohammed Ali Mr. Mohammed Ali has nothing to disclose.
GM Fahad Bin Mostafa (Texas Tech University) Mr. Mostafa has nothing to disclose.
Hafiz Khan, PhD (Texas Tech University Health Sciences Center) Dr. Khan has nothing to disclose.
Nizar Souayah, MD, FAAN Dr. Souayah has received publishing royalties from a publication relating to health care.