دورية أكاديمية
Ephedrine treatment for autoimmune myasthenia gravis.
العنوان: | Ephedrine treatment for autoimmune myasthenia gravis. |
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المؤلفون: | Lipka AF; Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: a.f.lipka@lumc.nl., Vrinten C; Department of Clinical Genetics and EMGO Institute for Health and Care Research, section Community Genetics & Public Health Genomics, VU University Medical Center, Amsterdam, The Netherlands; Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, United Kingdom., van Zwet EW; Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands., Schimmel KJ; Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands., Cornel MC; Department of Clinical Genetics and EMGO Institute for Health and Care Research, section Community Genetics & Public Health Genomics, VU University Medical Center, Amsterdam, The Netherlands., Kuijpers MR; Department of Care, Section Pharmaceutical Care, National Health Care Institute, Diemen, The Netherlands., Hekster YA; Department of Pharmacy, Radboud University Medical Center, Nijmegen, The Netherlands., Weinreich SS; Department of Clinical Genetics and EMGO Institute for Health and Care Research, section Community Genetics & Public Health Genomics, VU University Medical Center, Amsterdam, The Netherlands., Verschuuren JJ; Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands. |
المصدر: | Neuromuscular disorders : NMD [Neuromuscul Disord] 2017 Mar; Vol. 27 (3), pp. 259-265. Date of Electronic Publication: 2016 Nov 18. |
نوع المنشور: | Journal Article; Randomized Controlled Trial |
اللغة: | English |
بيانات الدورية: | Publisher: Pergamon Press Country of Publication: England NLM ID: 9111470 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-2364 (Electronic) Linking ISSN: 09608966 NLM ISO Abbreviation: Neuromuscul Disord Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: Oxford ; New York : Pergamon Press, c1991- |
مواضيع طبية MeSH: | Outcome Assessment, Health Care*, Ephedrine/*pharmacology , Immunosuppressive Agents/*therapeutic use , Myasthenia Gravis/*drug therapy , Receptors, Cholinergic/*immunology , Sympathomimetics/*pharmacology, Adult ; Autoantibodies/blood ; Cross-Over Studies ; Double-Blind Method ; Drug Therapy, Combination ; Ephedrine/administration & dosage ; Ephedrine/adverse effects ; Female ; Humans ; Immunosuppressive Agents/administration & dosage ; Middle Aged ; Myasthenia Gravis/immunology ; Sympathomimetics/administration & dosage ; Sympathomimetics/adverse effects |
مستخلص: | We studied the effect and safety of ephedrine as add-on treatment for patients with myasthenia gravis with acetylcholine receptor antibodies (AChR MG), who do not sufficiently respond to standard treatment. Four patients with AChR MG were included in a placebo-controlled, double-blind, and randomised, multiple crossover series of n-of-1 trials. Each n-of-1 trial consisted of 3 cycles, in which two 5-day intervention periods were followed by 2 days washout. In each cycle, ephedrine 50 mg daily in 2 doses was compared with placebo in the alternate treatment period. Primary outcome was a change in QMG score. Add-on treatment with ephedrine compared with placebo improved QMG score by 1.0 point (95% confidence interval 0.21-1.79), which was significant for the group of trial patients as well as for the population treatment effect. Ephedrine also showed a significant trial average treatment effect for all secondary outcomes, improving MG Composite by 2.7, MG-ADL by 1.0 and VAS score for muscle strength by 1.1. Adverse events were mild and included palpitations, tremor and restlessness. Although all ECGs were normal, ephedrine prolonged the corrected QT interval. Ephedrine as add-on treatment for myasthenia gravis resulted in a small but consistent reduction of symptoms and weakness in patients with moderate disease severity. (Copyright © 2016 Elsevier B.V. All rights reserved.) |
فهرسة مساهمة: | Keywords: Add-on therapy; Ephedrine; Myasthenia gravis; Randomised controlled trial; n-of-1 trial |
المشرفين على المادة: | 0 (Autoantibodies) 0 (Immunosuppressive Agents) 0 (Receptors, Cholinergic) 0 (Sympathomimetics) GN83C131XS (Ephedrine) |
تواريخ الأحداث: | Date Created: 20161224 Date Completed: 20180215 Latest Revision: 20191210 |
رمز التحديث: | 20221213 |
DOI: | 10.1016/j.nmd.2016.11.009 |
PMID: | 28007405 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1873-2364 |
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DOI: | 10.1016/j.nmd.2016.11.009 |