Comparison Of Efficacy Between Dexamethasone At Moderate Dose With Methylprednisolone Pulse In Treatment Of Patients With Generalized Myasthenia Gravis

Objective:To compare the efficacy and side effects of moderate dosage dexamethasone(DEX) with methylprednisolone(MP) pulse therapy both followed by slowly tapering to maintenance dosage prednisone in adult patients with generalized myasthenia gravis(GMG). Methods:49 patients were randomly divided into two groups by means of random number table. Among them, 25 were patients treated with moderate dosage DEX, while another 24 patients were treated with MP pulse therapy. The clinical score was obtained based on quantitative MG scores(QMGs)at pretreatment, the 1st and 3rd months after post-treatment, respectively. Visits by the patients occurred at the end of the each period(Month 1-day 30 and Month 3-day 90). Data were obtained regarding the side effects of glucocorticoid(GC) during the treatment visit. Results:Mean efficacy percentages of A and B groups at the 1st month posttreatment were 83% and 85%,P>0.05, while at the 3rd month both reached 100%, the differences were not significant. Two-group comparison – DEX and MP – failed to find a significant difference in the initial aggravation, side effects score in 4~10 days posttreatment were 0.80±0.98 and 0.77±0.93,P>0.05. Side effects percentages of the two groups at the 3rd month posttreatment were 29% and 49.4%, P<0.01. However, The incidence of Hyperglycemia, weight increment, infection and total side effects was significantly lower in the DEX group, as compared with the MP group. P<0.05. Conclusion:DEX therapy had an equal efficacy and less side effects when compared with MP therapy. DEX therapy is more suitable to be applied in clinical treatment.