SynthesisJournal of neurology2021
Exacerbation of myasthenia gravis following corticosteroid treatment: what is the evidence? A systematic review.
Synthesis in Journal of neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 47 citations in OpenAlex.
- Cystic Thymoma-Associated Fulminant Myasthenia Gravis with Rapid Progression in a Cat: Diagnostic and Therapeutic Challenges.Veterinary sciences · 2026Article
- Efgartigimod Combined with Glucocorticoids in the Treatment of Severe Generalized Myasthenia Gravis: A Single-Center, Retrospective Cohort Study.Neurology and therapy · 2026Article
- Use of Corticosteroids in Myasthenia Gravis: Expert Opinion for Daily Management.Neurology and therapy · 2025Article
- Article
- Contemporaneous Presentation of Ocular Myasthenia Gravis With Pituitary Apoplexy: A Diagnostic Dilemma.Cureus · 2025Article
- Article
- Myasthenia gravis and nutrition.Frontiers in nutrition · 2025Review
- Efgartigimod Followed by Telitacicept in Adult Generalized Myasthenia Gravis: A Retrospective Case Series.Journal of inflammation research · 2025Article
- Targeted Treatments for Myasthenia Gravis in Children and Adolescents.Paediatric drugs · 2024Review
- Immune checkpoint inhibitor-related myositis and myocarditis: diagnostic pitfalls and imaging contribution in a real-world, institutional case series.Journal of neurology · 2024Review
- Dexamethasone improves thymoma-associated myasthenia gravis via the AKT-mTOR pathway.Naunyn-Schmiedeberg's archives of pharmacology · 2024Article
- Comparative effectiveness and safety of intravenous methylprednisolone and tacrolimus monotherapy in ocular myasthenia gravis with unsatisfactory prednisone responses: a retrospective study.Orphanet journal of rare diseases · 2024Article
- Identifying patients at risk for myasthenic crisis with hemogram and inflammation-related laboratory parameters - a pilot study.Frontiers in neurology · 2024Article
- Myasthenia Gravis: A Systematic Review.Cureus · 2023Review
- Myasthenia gravis treatment in the elderly presents with a significant iatrogenic risk: a multicentric retrospective study.Journal of neurology · 2023Article
- Current management of myasthenia gravis in Belgium: a single-center experience.Acta neurologica Belgica · 2023Review
- Potentially inappropriate drug use in myasthenia gravis: a real-world population-based cohort study in Italy.Frontiers in neurology · 2023Article
- Pharmacotherapy of Generalized Myasthenia Gravis with Special Emphasis on Newer Biologicals.Drugs · 2022Review
- Drugs That Induce or Cause Deterioration of Myasthenia Gravis: An Update.Journal of clinical medicine · 2021Review
- Rare concurrent ocular myasthenia gravis and Graves' ophthalmopathy in a man with Poland syndrome: a case report.BMC neurology · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Corticosteroids (CS) are among the most widely- used immunosuppressive agents for immune-mediated conditions, including myasthenia gravis (MG). While their effectiveness in MG is documented and supported in the clinical practice over several decades, one of the main drawbacks of treatment results from the notion that MG patients may experience symptom worsening following CS treatment initiation. This may lead to the administration of lower than necessary doses of CS for the disorder, or even avoiding them altogether. As a consequence, some patients may not receive the optimal treatment to control their disease. In the present review, we analyzed 27 relevant publications and determined the prevalence of clinical exacerbation following CS treatment, its' severity and relation to the type and dose of CS. The rate of MG exacerbation is highest with the administration of cortisone, intermediate with prednisone, and lowest with methylprednisolone. High dose daily or alternate-day prednisone is associated with exacerbation more frequently than low-dose treatment, but most exacerbations are of mild to moderate severity. Other factors related to increased risk of an initial exacerbation include older age, generalized MG, bulbar symptoms, disease severity, presence of thymoma, and thymectomy. However, the current information is based mostly on heterogeneous studies of low quality, and prospective clinical trials designed to compare between the various agents and doses and assess the rate and severity of the exacerbation by a unified scale are warranted.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.