Starting steroids dose, need for additional immunosuppression and long-term outcome in Myasthenia Gravis (P3.159)

OBJECTIVE: Evaluate our therapeutic strategy regarding severity and age of patients, and if there are predictors of treatment response at disease onset. BACKGROUND: Steroids are first-line immunosuppressive treatment in Myasthenia Gravis (MG) and azathioprine the drug most widely used as additional immunosuppressive and steroid-sparing agentThe majority of patients attain excellent disease control over time. However, there is little data on what proportion of patients reaches favorable on low-dose immunotherapy.Some authors recommend starting treatment with high-dose steroids and add an additional immunosuppressive in elderly patients In our center, we begin a steroid treatment in a stepwise way according to clinical response, and postpone azathioprine due to clinical needs DESIGN/METHODS: MG generalized patients with a follow up u003e1year, who received steroids were included. We established as low dose 20 mg. MGFA and PIS were used to assess severity. MGFA ≤ II was considered low initial status RESULTS: 48 patients were included. Mean time of follow up was 6 years (1-23y).56.3[percnt] was men, the mean age was 68 (18-88). 66.7[percnt] had autoantibodies against AchR . 60.4[percnt] required u003c 20mg of meprednisone and 41.7[percnt] azathioprine in the follow up. There was no difference in initial MGFA and age between patients who required high or low doses of steroids and /or PIS at first year were more severe in patients who received high dose of steroids and azathioprine. CONCLUSIONS: Approximately half of our patients can be managed with low-dose medication Initial MGFA seems to be not predictor of high dose of steroid or azathioprine requirement. PIS at first year are associated with more immunosuppression needs.This findings support that initial doses of steroids might be low regardless initial status. Study Supported by: Disclosure: Dr. rugiero has nothing to disclose. Dr. Bettini has nothing to disclose. Dr. Chaves has nothing to disclose. Dr. Araoz has nothing to disclose. Dr. Cristiano has received personal compensation for activities with Bayer, Biogen Idec, Merck u0026 Co., Inc., and Novartis.