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Clinical effect of tacrolimus in the treatment of myasthenia gravis in children / 中国当代儿科杂志
Chinese Journal of Contemporary Pediatrics ; (12): 964-969, 2020.
Article in Chinese | WPRIM | ID: wpr-828637
ABSTRACT
OBJECTIVE@#To evaluate the efficacy and safety of tacrolimus in the treatment of children with myasthenia gravis (MG).@*METHODS@#A total of 28 children with MG were treated with tacrolimus. MG-Activities of Daily Living (MG-ADL) scale was used to assess clinical outcome and safety after 1, 3, 6, 9, and 12 months of treatment.@*RESULTS@#After tacrolimus treatment, the MG-ADL score at 1, 3, 6, 9 and 12 months was lower than that at baseline (P<0.05), and the MG-ADL score showed a gradually decreasing trend. The response rates to tacrolimus treatment at 1, 3, 6, 9, and 12 months were 59%, 81%, 84%, 88%, and 88% respectively. At 6, 9, 12, and 18 months of treatment, 4, 13, 14, and 15 children respectively were withdrawn from prednisone. No recurrence was observed during treatment. Major adverse reactions/events were asymptomatic reduction in blood magnesium in 5 children and positive urine occult blood in 1 child, which turned negative without special treatment, and tacrolimus was not stopped due to such adverse reactions/events. One child was withdrawn from tacrolimus due to recurrent vomiting. According to CYP3A5 genotypes, all of the patients were divided into two groups slow metabolic type (n=19) and non-slow metabolic type (fast metabolic type + intermediate type; n=9). The non-slow metabolism group received a higher dose of tacrolimus, but had a lower trough concentration of tacrolimus than the slow metabolism group (P<0.05). The slow metabolism group had a higher response rates to tacrolimus treatment than the non-slow metabolism group (P<0.05).@*CONCLUSIONS@#Tacrolimus appears to be effective and safe in the treatment of children with MG and is thus an option for immunosuppressive therapy. CYP3A5 genotyping has a certain guiding significance for determining the dosage of tacrolimus.
Subject(s)
Full text: Available Index: WPRIM (Western Pacific) Main subject: Activities of Daily Living / Tacrolimus / Therapeutic Uses / Drug Therapy / Immunosuppressive Agents / Myasthenia Gravis / Neoplasm Recurrence, Local Limits: Child / Humans Language: Chinese Journal: Chinese Journal of Contemporary Pediatrics Year: 2020 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Activities of Daily Living / Tacrolimus / Therapeutic Uses / Drug Therapy / Immunosuppressive Agents / Myasthenia Gravis / Neoplasm Recurrence, Local Limits: Child / Humans Language: Chinese Journal: Chinese Journal of Contemporary Pediatrics Year: 2020 Type: Article