Letter to the Editor

Low-Dose Azathioprine Effectively Suppresses Clinical and Immunological Manifestations of Generalized Myasthenia

Authors: Josef Finsterer, MD, PhD, Marlies Frank, MD, Elisabeth Krexner, MD

Abstract

To the Editor:


Azathioprine (AZT) is the treatment of choice for long-term immunosuppression in patients with myasthenia gravis (MG).1,2 There is some evidence that reduction of the standard dosage is ineffective, but some studies even report ineffectivity of the standard AZT dosage for generalized MG.3 We show that low-dose AZT may also effectively suppress acetylcholine-receptor antibodies (AchR-abs) and clinical manifestations of generalized MG.

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References

1.Kommission “Leitlinien der Deutschen Gesellschaft für Neurologie” (ed): Leitlinien für Diagnostik und Therapie in der Neurologie. Thieme Verlag, 4, überarbeitete Auflage, 2008.
 
2.Palace J, Newsom-Davis J, Lecky B; Myasthenia Gravis Study Group. A randomized double-blind trial of prednisolone alone or with azathioprine in myasthenia gravis. Neurology 1998;50:1778–1783.
 
3.Hart IK, Sharshar T, Sathasivam S. Immunosuppressant drugs for myasthenia gravis. J Neurol Neurosurg Psychiatry 2009;80: 5–6.
 
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5.Witte AS, Cornblath DR, Schatz NJ, et al. Monitoring azathioprine therapy in myasthenia gravis. Neurology 1986;36:1533–1534.