November 1997

Controlled Clinical Trials of Anything in Myasthenia Gravis

Author Affiliations

Department of Neurology Indiana University School of Medicine 1050 W Walnut St RG-6 Indianapolis, IN 46202

Arch Neurol. 1997;54(11):1323. doi:10.1001/archneur.1997.00550230006003

In his letter discussing the article by Kupersmith et al1 on corticosteroid treatment for ocular myasthenia gravis, McQuillen2 emphasizes that Kupersmith et al "neglected to mention the only controlled clinical trial of anything in myasthenia—namely of corticotropin" citing the article by Mount.3 For the record, there have been other controlled trials of therapy in myasthenia gravis. In 1976 Howard et al4 from the Mayo Clinic, Rochester, Minn, reported, "Alternate-day prednisone: preliminary report of a double-blind controlled study" in which prednisone, 100 mg alternate day, was given to patients with moderately severe myasthenia gravis. Thirteen patients were followed up for 6 months. Six of the patients were receiving prednisone, 3 of whom improved. Seven patients were receiving placebo, of whom "three were improved and had minimal disability well controlled by small amounts of anticholinesterase medication." The authors3 further state that "finally, any evaluation of treatment of

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