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Acquired myasthenia gravis, a disorder of neuromuscular transmission, results from the binding of autoantibodies to acetylcholine receptors. The efficacy of treatment with thymectomy has remained controversial.
This randomized trial included 126 patients with generalized nonthymomatous myasthenia gravis of less than 5 years' duration. All had Myasthenia Gravis Foundation of America clinical class II to IV disease and elevated concentrations of acetylcholine-receptor antibody. The interventions were thymectomy plus prednisone versus prednisone alone.
Those who underwent thymectomy had a lower time-weighted average Quantitive Myasthenia Gravis score during a 3-year period than those on prednisone alone (6.15 vs. 8.99; P<0.001). The thymectomy g…