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Factors influencing outcome of prednisone dose reduction in myasthenia gravis

Neuro-Ophthalmology Service (Drs. Miano, Bosley, Sergott, Savino, and Schatz), Wills Eye Hospital, and the Neurology Department (Dr. Heiman-Patterson), Thomas Jefferson University Hospital, Philadelphia, PA; and the Research Department (Dr. Reed), Lehigh Valley Hospital Center, Allentown, PA.

We reviewed retrospectively 114 prednisone dose reduction attempts in 63 myasthenic patients. Dose reduction was considered successful if a patient remained asymptomatic for more than 1 year on no prednisone or a stable low dose of prednisone. Successful dose reduction attempts were more common in patients taking azathioprine, but thymectomy did not influence taper outcome. Slower rate of dose reduction and higher ending dose of prednisone improved the chance of success.

Address correspondence and reprint requests to Dr. T.M. Bosley, Neuro-Ophthalmology Service, Wills Eye Hospital, 9th and Walnut Streets, Philadelphia, PA 19107.

Dr. Miano was supported by the National Institutes of Health Grant #5T35HD07217 and the Eastern Pennsylvania Chapter of the Myasthenia Gravis Foundation.

Received June 27, 1990. Accepted for publication in final form November 5, 1990.

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