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Yuyao Peng, Fei Jiang, Ran Zhou, Wanlin Jin, Yi Li, Weiwei Duan, Liqun Xu, Huan Yang Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, People’s Republic of ChinaCorrespondence: Liqun Xu; Huan YangDepartment of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, People’s Republic of ChinaTel +86 731-8432-7236Fax +86 731-8432-7401Email lilyxu1983@126.com; 403850@csu.edu.cnBackground: Tacrolimus has been recommended as an effective immunosuppressant for patients with myasthenia gravis (MG), while the high price, variable bioavailability, and narrow therapeutic window restrict its clinical application. Wuzhi capsule (WZC) could improve tacrolimus blood concentration by inhibiting the metabolism of cytochrome P450 3A (CYP3A) and P-glycoprotein (P-gp). There are few studies focused on the coadministration of WZC and tacrolimus in autoimmune diseases. This study was aimed at quantifying the efficacy and safety of coadministration of WZC and tacrolimus in adult Chinese patients with MG.Methods: In this retrospective study, 122 patients with MG on tacrolimus were enrolled. The initial tacrolimus dose was 2 mg/d. Patients with standard initial tacrolimus concentration were classified into group A (standard-dose group). Those failed to reach target concentration were divided into group B (high-dose group) and group C (co-administering WZC group), according to treatment adjustment of increasing tacrolimus dose and co-administration of WZC, respectively. A logistic analysis was used to identify factors associated with clinical outcome. Adverse drug reactions (ADRs) were recorded for safety analysis.Results: The tacrolimus concentration after coadministration of WZC was remarkably increased. It was higher compared with simply increasing the tacrolimus dose (p< 0.001). The multivariate logistic analysis indicated that the baseline quantitative MG score was a predictive factor for clinical outcomes (OR=0.189; 95% CI 0

Di Chen, Yuyao Peng, Zhibin Li, Wanlin Jin, Ran Zhou, Yi Li, Qiushuang Xu, Huan Yang Department of Neurology, Xiangya Hospital, Central South University, Changsha 410008, People’s Republic of ChinaCorrespondence: Huan YangDepartment of Neurology, Xiangya Hospital, Central South University, Changsha 410008, People’s Republic of ChinaEmail yangh69@126.comBackground: Myasthenia gravis (MG) is an autoantibody-mediated neuromuscular disorder. Approximately 10– 20% of all MG patients experience thymoma (benign tumor arising from thymus tissue). Thymectomy has been the standard of care for thymomatous myasthenia gravis (TMG). However, the clinical outcome of TMG after thymectomy has not been sufficiently studied, especially the long-term prognosis. Therefore, the aim of this study was to analyze the clinical characteristics contributing to the prognostic factors of TMG.Methods: We reviewed 70 TMG patients in the Xiangya Hospital and classified them into the minimal manifestation (MM) group and No MM group, according to the long-term treatment outcome. MM-or-better status was defined as the goal treatment for TMG patients. We collected and analyzed the demographic data, the WHO classification of thymoma, MG-associated antibody levels, disease severity, treatment-related data as well as clinical outcome at six months. Variables selected by univariate analysis were used in the multivariate logistic regression model to identify the prognostic factors.Results: The differences in clinical outcome at six months and worst QMGS were significant, while the differences in other factors were insignificant between groups. Clinical outcome at six months (OR=23.5 95% CI 2.4– 231.5, P=0.007) and dyspnea before thymectomy (OR=0.2, 95% CI 0.03– 0.75, P=0.021) were identified as the prognostic factors of long-term treatment.Conclusion: Demographic and clinical features were similar in TMG patients treated at our hospital. The early achievemen