Clinical Improvement Mirrored Antibody Reduction in Myasthenia Gravis
Abstract
ABSTRACT OF THE THESIS
Clinical Improvement Mirrored Antibody Reduction in Myasthenia Gravis by Isela Stephanie Hernandez Master of Science in Biomedical and Translational Science University of California, Irvine, 2022 Professor Tahseen Mozaffar, Chair
Introduction: The relationship of anti-acetylcholine receptor (AChR) antibody levels to treatment response remains unclear in seropositive myasthenia gravis (MG) patients.Objective: To examine whether changes in AChR antibody level (ΔAb) correlate with clinical response in subjects in the Thymectomy in Myasthenia Gravis Trial (MGTX). Methods: Post-hoc analysis of the MGTX antibody level dataset at baseline, 12, 24, 36 months. Changes in Myasthenia Gravis Activities of Daily Living (ΔMG-ADL) and Quantitative Myasthenia Gravis (ΔQMG) scores compared to ΔAb between the thymectomy+prednisone versus prednisone only groups. Statistical methods included bivariate linear regression, Spearman correlation and Mann-Whitney test. Results: Data from 86/126 enrolled subjects, including outliers, was analyzed. Correlation with ΔMG-ADL was statistically significant at 12 and 24 months (P 0.0397 and 0.0008 respectively). ΔQMG and ΔAb directly correlated at all 3 timepoints [P= 0.0032, P= 0.0031, P=0.0005, respectively]. Conclusion: Reductions in AChR antibody level generally correlated, in both treatment arms, with improvement in QMG and MG-ADL scores, confirming the utility of monitoring antibody levels in clinical practice to follow treatment response.