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Meel, R.H.P. de; Barnett, C.; Bril, V.; Tannemaat, M.R.; Verschuuren, J.J.G.M. (2020)

Myasthenia gravis impairment index: sensitivity for change in generalized muscle weakness

Article / Letter to editor
Introduction: The recently developed Myasthenia Gravis Impairment Index (MGII) is a promising measure as it has less floor effects and a higher relative efficiency in its responsiveness to treatment effect compared to other MG measures. This study aimed at validating the MGII in a Dutch cohort of MG patients and analyzing the sensitivity of MGII compared to MG-ADL for changes in generalized weakness.Methods: We analyzed (generalized items of; -gen) MGII, quantitative myasthenia gravis (QMG), Myasthenia Gravis Activities of Daily Living (MG-ADL), EQ-5D visual analog, Myasthenia Gravis Composite (MGC) and ACTIVLIM (an ADL questionnaire focusing on generalized weakness) scores in a prospective cohort of 99 MG patients. We investigated correlations between MGII and other outcome measures. We used a generalized linear model to assess whether MGIIgen had an additional sensitivity on top of MG-ADLgen for changes (A) in QMGgen in individual patients.Results: MGII had a lower floor effect (4...Show moreIntroduction: The recently developed Myasthenia Gravis Impairment Index (MGII) is a promising measure as it has less floor effects and a higher relative efficiency in its responsiveness to treatment effect compared to other MG measures. This study aimed at validating the MGII in a Dutch cohort of MG patients and analyzing the sensitivity of MGII compared to MG-ADL for changes in generalized weakness.Methods: We analyzed (generalized items of; -gen) MGII, quantitative myasthenia gravis (QMG), Myasthenia Gravis Activities of Daily Living (MG-ADL), EQ-5D visual analog, Myasthenia Gravis Composite (MGC) and ACTIVLIM (an ADL questionnaire focusing on generalized weakness) scores in a prospective cohort of 99 MG patients. We investigated correlations between MGII and other outcome measures. We used a generalized linear model to assess whether MGIIgen had an additional sensitivity on top of MG-ADLgen for changes (A) in QMGgen in individual patients.Results: MGII had a lower floor effect (4%) compared to QMG (6%), MG-ADL (11%) and MGC (16%). MGII correlated well with QMG (r = 0.68), MG-ADL (r = 0.83) and MGC (r = 0.74). As expected, the correlations with EQ visual analog and ACTIVLIM were lower (r = -0.57 and -0.48). AMGIIgen had an additional value on top of AMG-ADLgen in the prediction of Delta QMGgen (B = 0.54, p = 0.01).Discussion: The MGII score was cross-culturally validated in a Dutch cohort of MG patients. MGII had a higher sensitivity for generalized weakness than MG-ADL.Show less
Myasthenia gravis
MGII
MG-ADL
QMG
generalized weakness
All authors
Meel, R.H.P. de; Barnett, C.; Bril, V.; Tannemaat, M.R.; Verschuuren, J.J.G.M.
Date
2020-01-01
Journal
Journal of Neuromuscular Diseases
Volume
7
Issue
3
Pages
297 - 300
DOI
doi:10.3233/JND-200484
Link
https://content.iospress.com/articles/journal-of-neuromuscular-diseases/...