Submitted by: Shan Chen, MD
Edited by: Rebecca A. O'Bryan, MD
Klimiec-Moskal E, Quirke M, Leite MI. Comorbidities in older patients with myasthenia gravis - Comparison between early- and late-onset disease. Acta Neurol Scand
. 2022;145(3):371-374. doi:10.1111/ane.13549
Based on the age of onset, myasthenia gravis (MG) is differentiated into early-onset (EOMG) and late-onset (LOMG).
The population of older MG patients is complex and includes EOMG with a long duration of MG treatment and LOMG who often had other health issues before MG onset.
This study’s aim was to investigate comorbidities in the older population and compare EOMG and LOMG myasthenia patients. The age of 50 is used as the cutoff to differentiate EOMG and LOMG.
The authors investigated clinical information of patients from Oxford Myasthenia Centre age 50 or older. In total, the study included 327 myasthenia patients (30.9% EOMG and 69.1% LOMG) with a median age of 70 years. They extracted 60 chronic disorders. Comorbidities were present in 94.5% of patients and accumulated with age. Hypertension (58.4% vs. 31.7%), hypercholesterolemia (41.2% vs. 23.8%), diabetes (24.8% vs. 11.9%), cataract (15.5% vs. 5.0%) and prostate disorders (15.0% vs. 2.0%) were more common in LOMG than EOMG, but there were no differences between 70 EOMG and 70 LOMG patients matched according to age and sex.
This article demonstrated that c
omorbidities in older patients with MG are very common (>90%), increase with age, and do not differ between early- and late-onset disease. Among them, hypertension, hypercholesterolemia, diabetes and thyroid disease are the most common ones. These often can have greater impact on quality of life and outcome than symptoms of MG.
Future directions could include comparison of comorbidity prevalence related to MG therapy type.