Evidence map›Paper›PMID 42842206›Full record

ReviewEuropean geriatric medicine2026

Very late-onset myasthenia gravis: a systematic review and meta-analysis of clinical severity and long-term outcomes.

Ioannis Liampas, Silvia Demiri, Antonis Polyviou, Alessandro D'Orsi, Vasileios Siokas, Dimitra Veltsista, Efthimios Dardiotis, Elisabeth Chroni

Abstract readReview
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In one paragraph

Review in European geriatric medicine, 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.

Ioannis LiampasDepartment of Neurology, School of Medicine, University of Thessaly, Mezourlo, 41110, Larissa, Greece. iliampas@uth.gr.ORCID http://orcid.org/0000-0002-2958-5220
Silvia DemiriDepartment of Neurology, School of Medicine, University of Patras, 26504, Rio, Achaia, Greece.
Antonis PolyviouDepartment of Neurology, School of Medicine, University of Patras, 26504, Rio, Achaia, Greece.
Alessandro D'OrsiDepartment of Neurology, School of Medicine, University of Patras, 26504, Rio, Achaia, Greece.
Vasileios SiokasDepartment of Neurology, School of Medicine, University of Thessaly, Mezourlo, 41110, Larissa, Greece.
Dimitra VeltsistaDepartment of Neurology, School of Medicine, University of Patras, 26504, Rio, Achaia, Greece.
Efthimios DardiotisDepartment of Neurology, School of Medicine, University of Thessaly, Mezourlo, 41110, Larissa, Greece.
Elisabeth ChroniDepartment of Neurology, School of Medicine, University of Patras, 26504, Rio, Achaia, Greece.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeVery late-onset myasthenia gravis (vloMG; onset ≥ 65 years) may represent a clinically distinct subgroup, but its severity and prognosis remain uncertain. We systematically reviewed studies comparing vloMG with earlier-onset MG (non-vloMG) and examined whether findings differed from the conventional early-onset (EOMG) versus late-onset dichotomy (LOMG; ≥ 50 years).

methodsMEDLINE, Embase, CENTRAL, and Google Scholar were searched from inception to May 2026. Observational studies of adult MG comparing age-at-onset groups were eligible. The main quantitative outcome was severe early presentation, defined as Myasthenia Gravis Foundation of America (MGFA) class IV-V early at the disease course (at onset, diagnosis, or the earliest pretreatment assessment). Other baseline and longitudinal outcomes were summarized qualitatively because outcome definitions and follow-up duration were heterogeneous.

resultsTen studies were included. Four studies including 647 patients with vloMG and 1,620 with non-vloMG contributed to the primary meta-analysis. Severe early presentation was more frequent in vloMG than in non-vloMG (10.2% vs 3.8%; Odds Ratio 2.19, 95%CI 1.49-3.24; p < 0.001; I

conclusionvloMG is associated with more severe early presentation, but long-term disease control may not differ from non-vloMG. Future studies should standardize age strata, follow-up, treatment exposure, and confounder adjustment.

Indexed as

Late-onset MGMyasthenic crisisPrognosisRefractory MGVery late-onset MG

Identifiers

PMID42842206

What OpenQuestion holds

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Registered trials

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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.