Evidence map›Paper›PMID 41823508›Full record

ArticleEuropean journal of neurology2026

Who Can Safely Discontinue Treatment in Myasthenia Gravis? Insights From a Long-Term Real-World Study.

Dingxian He, Chong Yan, Baitong Wang, Yanlei Yang, Shengying Gu, Jianying Xi, Sushan Luo, Chongbo Zhao

Abstract read
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In one paragraph

Article in European journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

8 authors.

Dingxian HeHuashan Rare Disease Centre and Department of Neurology, Huashan Hospital, Shanghai Medical College, National Centre for Neurological Disorders, Fudan University, Shanghai, China.
Chong YanHuashan Rare Disease Centre and Department of Neurology, Huashan Hospital, Shanghai Medical College, National Centre for Neurological Disorders, Fudan University, Shanghai, China.
Baitong WangDepartment of Encephalopathy, The Affiliated Hospital to Changchun University of Chinese Medicine, Jilin, Changchun, China.
Yanlei YangDepartment of Neurology, Southern Central Hospital of Yunnan Province (The First People's Hospital of Honghe Prefecture), Gejiu, Yunnan, China.
Shengying GuHuashan Rare Disease Centre and Department of Neurology, Huashan Hospital, Shanghai Medical College, National Centre for Neurological Disorders, Fudan University, Shanghai, China.
Jianying XiHuashan Rare Disease Centre and Department of Neurology, Huashan Hospital, Shanghai Medical College, National Centre for Neurological Disorders, Fudan University, Shanghai, China.
Sushan LuoHuashan Rare Disease Centre and Department of Neurology, Huashan Hospital, Shanghai Medical College, National Centre for Neurological Disorders, Fudan University, Shanghai, China.ORCID https://orcid.org/0000-0002-9033-7568
Chongbo ZhaoHuashan Rare Disease Centre and Department of Neurology, Huashan Hospital, Shanghai Medical College, National Centre for Neurological Disorders, Fudan University, Shanghai, China.ORCID https://orcid.org/0000-0001-9481-1418

Funding

National Clinical Collaboration Project for Major and Difficult Diseases with Integrated Traditional Chinese and Western Medicine Document No. GTCM Integration Letter [2023] No. 250National Natural Science Foundation of China 82471426National Natural Science Foundation of China 82571592
6 · The paper itself

Abstract

backgroundOptimal timing for treatment discontinuation in myasthenia gravis (MG) patients achieving minimal symptom expression (MSE) remains undefined.

methodsThis prospective cohort study enrolled 196 MG patients from the Huashan MG Registry who achieved MSE and subsequently discontinued all treatments. Cox regression was used to identify prognostic factors for relapse. Among these, 20 patients experienced two discontinuation events and were analyzed separately for their second discontinuation.

resultsOver a mean follow-up of 111.10 months, 108 patients (55.1%) experienced relapse. Multivariate analysis identified four independent prognostic factors: onset age ≥ 50 years as a risk factor (HR 1.68, 95% CI 1.04-2.70, p = 0.032), and rituximab administration (HR 0.43, 95% CI 0.17-0.89, p = 0.015), treatment duration ≥ 14.3 months (HR 0.54, 95% CI 0.34-0.85, p = 0.008), and time from MSE to discontinuation ≥ 6.1 months (HR 0.51, 95% CI 0.32-0.83, p = 0.007) as protective factors. Infection, fatigue, and psychological stress were common relapse triggers.

conclusionsComplete treatment discontinuation after MSE in MG carries substantial relapse risk. Individualized discontinuation decisions incorporating younger onset age, prior rituximab use, adequate treatment and consolidation duration may optimize outcomes.

Indexed as

Immunologic FactorsMyasthenia GravisRituximabAdultAgedAge of OnsetFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisProspective StudiesRecurrenceRegistriesTreatment InterruptionImmunologic FactorsRituximabminimal symptom expressionmyasthenia gravisprognostic factorsrelapsetreatment discontinuation

Identifiers

PMID41823508
PMCPMC13093717

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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.