Evidence map›Paper›PMID 41118002›Full record

Observational studyJournal of neurology2025

Long-term effectiveness of thymectomy in late-onset myasthenia gravis.

Ester Latini, Melania Guida, Carmelina Cristina Zirafa, Stefania Rizzo, Alba Cepele, Gaetano Romano, Vittorio Aprile, Marco Lucchi, Gabriele Siciliano, Roberta Ricciardi and 1 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Ester LatiniDepartment of Experimental and Clinical Medicine, Division of Geriatric and Intensive Care Medicine, University of Florence, Viale Brambilla, 3, Firenze, Italy. ester.latini@unifi.it.ORCID http://orcid.org/0009-0000-7474-3681
Melania GuidaDepartment of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Via Roma 55, Pisa, Italy.
Carmelina Cristina ZirafaMinimally Invasive and Robotic Thoracic Surgery-Surgical, Medical, Molecular and Critical Care Pathology Department, University Hospital of Pisa, Pisa, Italy.
Stefania RizzoNeurology Unit, ASL Salerno, Agropoli, Italy.
Alba CepeleDepartment of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Via Roma 55, Pisa, Italy.
Gaetano RomanoMinimally Invasive and Robotic Thoracic Surgery-Surgical, Medical, Molecular and Critical Care Pathology Department, University Hospital of Pisa, Pisa, Italy.
Vittorio AprileMinimally Invasive and Robotic Thoracic Surgery-Surgical, Medical, Molecular and Critical Care Pathology Department, University Hospital of Pisa, Pisa, Italy.
Marco LucchiDivision of Thoracic Surgery, Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy.
Gabriele SicilianoDepartment of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Via Roma 55, Pisa, Italy.
Roberta RicciardiDepartment of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Via Roma 55, Pisa, Italy.
Michelangelo Maestri TassoniDepartment of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Via Roma 55, Pisa, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThymectomy is a well-established treatment in anti-AChR generalized myasthenia gravis (gMG) patients aged 18-50 years. However, the MGTX trial failed to prove an additional benefit of thymectomy in late-onset MG (LOMG) patients and studies conducted so far have shown controversial results. The primary aim of this study was to assess the safety and effectiveness of thymectomy in LOMG patients compared to medical therapy alone.

methodsThis was an observational retrospective case-control study of LOMG patients followed at the MG Clinic of Pisa University Hospital from 1996 to 2024. Inclusion criteria were: diagnosis of non-thymomatous gMG with anti-AChR antibodies; age at onset ≥ 50 years, and minimum follow-up of 12 months. The cumulative incidence of disease remission between the thymectomy and the conservative group was compared with Kaplan-Meier analysis with log-rank test and the Cox regression model was used to estimate the effect of thymectomy on achieving remission after adjustment for confounding variables.

resultsAmong our population of 127 LOMG patients, 87 patients underwent thymectomy, while 40 patients received medical treatment only. When evaluating neurological outcomes at the last follow-up, the thymectomy group had a 3.25-fold (HR = 3.25, 95% CI 1.31-8.1) increased probability of achieving disease remission than the conservative group, after adjustment for confounding variables.

conclusionOur findings suggest that thymectomy may be a feasible and potentially beneficial therapeutic option in this MG subgroup, possibly increasing the likelihood of disease remission without ongoing immunosuppressive therapy.

Indexed as

Myasthenia GravisThymectomyAdolescentAdultAgedAge of OnsetCase-Control StudiesFemaleFollow-Up StudiesHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeYoung AdultAnti-AChR AbGeneralized myasthenia gravisLate onset myasthenia gravisMyasthenia gravisThymectomyThymic atrophyThymic hyperplasiaVery late onset myasthenia gravis

Identifiers

PMID41118002
PMCPMC12540559

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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.