Myasthenia gravis (MG) is a neuromuscular disease characterized by varying degrees of skeletal muscle weakness. In patients with generalized MG, the tapering of prednisone therapy is a therapeutic dilemma for clinicians. This study aims to compare the efficacy of the standard slow-tapering regimen of prednisone therapy with a rapid-tapering regimen.
This multicenter, single-blind, randomized, parallel trial included a total of 2,291 patients with a confirmed diagnosis of moderate to severe generalized MG. The participants were divided into two arms: the slow tapering arm with a gradual decrease of the prednisone dose and the rapid-tapering arm with immediately high-dose daily administration of prednisone. The primary outcome of the study was the attainment of minimal manifestation status of MG without prednisone at 12 months.
Of 2,291 participants, only 117 patients were randomized into the two groups. The findings suggested that the proportion of patients who met the primary outcome was higher in the rapid tapering arm group (39%) compared with patients in the slow tapering arm group (9%). The incidence of severe adverse events did not differ significantly in the two groups.
The research concluded that rapid tapering of prednisone was a feasible treatment option for patients with moderate to severe generalized MG.