Abstract
Introduction: Myasthenia gravis (MG) is a rare autoimmune disorder of the neuromuscular junction. MG epidemiology has not been studied in Poland in a nationwide study before. Methods: Our epidemiological data were drawn from the National Health Fund (Narodowy Fundusz Zdrowia, NFZ) database; an MG patient was defined as a person who received at least once medical service coded in ICD-10 as MG (G70) and at least 2 reimbursed prescriptions for pyridostigmine bromide (Mestinon®) or ambenonium chloride (Mytelase®) in 2 consecutive years. Results: On 1st of January 2019, 8,702 patients with MG were receiving symptomatic treatment (female:male ratio: 1.65:1). MG incidence was 2.36/100,000. The mean age of incident cases in 2018 was 61.37 years, 59.17 years for women and 64.12 years for men. Incidence of early-onset MG (<50 years) was 0.80/100,000 and 4.98/100,000 for late-onset MG (LOMG), with male predominance in LOMG. Prevalence was 22.65/100,000. In women, there was a constant increase in prevalence of symptomatic MG from the first decade of life up to 80–89 years. In men, an increase in prevalence appeared in the 6th decade. The highest prevalence was observed in the age group of 80–89 years: 59.65/100,000 in women and 96.25/100,000 in men. Conclusions: Our findings provide information on epidemiology of MG in Poland and can serve as a tool to evaluate healthcare resources needed for MG patients.
References
1.
Lindstrom
JM
, Seybold
ME
, Lennon
VA
, Whittingham
S
, Duane
DD
. Antibody to acetylcholine receptor in myasthenia gravis. Prevalence, clinical correlates, and diagnostic value
. Neurology
. 1976 Nov
;26
(11
):1054
–9
. .2.
Hoch
W
, McConville
J
, Helms
S
, Newsom-Davis
J
, Melms
A
, Vincent
A
. Auto-antibodies to the receptor tyrosine kinase MuSK in patients with myasthenia gravis without acetylcholine receptor antibodies
. Nat Med
. 2001 Mar
;7
(3
):365
–8
. .3.
Gilhus
NE
, Owe
JF
, Hoff
JM
, Romi
F
, Skeie
GO
, Aarli
JA
. Myasthenia gravis: a review of available treatment approaches
. Autoimmune Dis
. 2011
;2011
:847393
. .4.
Sanders
DB
, Wolfe
GI
, Benatar
M
, Evoli
A
, Gilhus
NE
, Illa
I
, et al. International consensus guidance for management of myasthenia gravis: executive summary
. Neurology
. 2016 Jul 26
;87
(4
):419
–25
. .5.
Breiner
A
, Widdifield
J
, Katzberg
HD
, Barnett
C
, Bril
V
, Tu
K
. Epidemiology of myasthenia gravis in Ontario, Canada
. Neuromuscul Disord
. 2016 Jan
;26
(1
):41
–6
. .6.
Andersen
JB
, Engeland
A
, Owe
JF
, Gilhus
NE
. Myasthenia gravis requiring pyridostigmine treatment in a national population cohort
. Eur J Neurol
. 2010 Dec
;17
(12
):1445
–50
. .7.
Gattellari
M
, Goumas
C
, Worthington
JM
. A national epidemiological study of myasthenia gravis in Australia
. Eur J Neurol
. 2012 Nov
;19
(11
):1413
–20
. .8.
MacDonald
BK
, Cockerell
OC
, Sander
JW
, Shorvon
SD
. The incidence and lifetime prevalence of neurological disorders in a prospective community-based study in the UK
. Brain
. 2000 Apr
;123
(Pt 4
):665
–76
. .9.
Aragones
JM
, Bolibar
I
, Bonfill
X
, Bufill
E
, Mummany
A
, Alonso
F
, et al. Myasthenia gravis: a higher than expected incidence in the elderly
. Neurology
. 2003 Mar 25
;60
(6
):1024
–6
.10.
Casetta
I
, Groppo
E
, De Gennaro
R
, Cesnik
E
, Piccolo
L
, Volpato
S
, et al. Myasthenia gravis: a changing pattern of incidence
. J Neurol
. 2010 Dec
;257
(12
):2015
–9
. .11.
Lai
CH
, Tseng
HF
. Nationwide population-based epidemiological study of myasthenia gravis in Taiwan
. Neuroepidemiology
. 2010
;35
(1
):66
–71
. .12.
Maddison
P
, Ambrose
PA
, Sadalage
G
, Vincent
A
. A prospective study of the incidence of myasthenia gravis in the East Midlands of England
. Neuroepidemiology
. 2019
;53
(1–2
):93
–9
. .13.
Pedersen
EG
, Hallas
J
, Hansen
K
, Jensen
PE
, Gaist
D
. Late-onset myasthenia not on the increase: a nationwide register study in Denmark, 1996–2009
. Eur J Neurol
. 2013 Feb
;20
(2
):309
–14
.14.
Santos
E
, Coutinho
E
, Moreira
I
, Silva
AM
, Lopes
D
, Costa
H
, et al. Epidemiology of myasthenia gravis in Northern Portugal: frequency estimates and clinical epidemiological distribution of cases
. Muscle Nerve
. 2016 Sep
;54
(3
):413
–21
. .15.
Oopik
M
, Kaasik
AE
, Jakobsen
J
. A population based epidemiological study on myasthenia gravis in Estonia
. J Neurol Neurosurg Psychiatry
. 2003 Dec
;74
(12
):1638
–43
.16.
Vincent
A
, Clover
L
, Buckley
C
, Grimley Evans
J
, Rothwell
PM
, Survey
UKMG
. Evidence of underdiagnosis of myasthenia gravis in older people
. J Neurol Neurosurg Psychiatry
. 2003 Aug
;74
(8
):1105
–8
. .17.
Lavrnic
D
, Basta
I
, Rakocevic-Stojanovic
V
, Stevic
Z
, Peric
S
, Nikolic
A
, et al. Epidemiological study of adult-onset myasthenia gravis in the area of Belgrade (Serbia) in the period 1979–2008
. Neuroepidemiology
. 2013
;40
(3
):190
–4
.18.
Zieda
A
, Ravina
K
, Glazere
I
, Pelcere
L
, Naudina
MS
, Liepina
L
, et al. A nationwide epidemiological study of myasthenia gravis in Latvia
. Eur J Neurol
. 2018 Mar
;25
(3
):519
–26
. .19.
Somnier
FE
, Keiding
N
, Paulson
OB
. Epidemiology of myasthenia gravis in Denmark. A longitudinal and comprehensive population survey
. Arch Neurol
. 1991 Jul
;48
(7
):733
–9
.20.
Matsui
N
, Nakane
S
, Nakagawa
Y
, Kondo
K
, Mitsui
T
, Matsumoto
T
, et al. Increasing incidence of elderly onset patients with myasthenia gravis in a local area of Japan
. J Neurol Neurosurg Psychiatry
. 2009 Oct
;80
(10
):1168
–71
. .21.
Pakzad
Z
, Aziz
T
, Oger
J
. Increasing incidence of myasthenia gravis among elderly in British Columbia, Canada
. Neurology
. 2011 Apr 26
;76
(17
):1526
–8
. .22.
Alkhawajah
NM
, Oger
J
. Late-onset myasthenia gravis: a review when incidence in older adults keeps increasing
. Muscle Nerve
. 2013 Nov
;48
(5
):705
–10
. .23.
Martinka
I
, Fulova
M
, Spalekova
M
, Spalek
P
. Epidemiology of myasthenia gravis in Slovakia in the years 1977–2015
. Neuroepidemiology
. 2018
;50
(3–4
):153
–9
. .24.
Carr
AS
, Cardwell
CR
, McCarron
PO
, McConville
J
. A systematic review of population based epidemiological studies in myasthenia gravis
. BMC Neurol
. 2010 Jun 18
;10
:46
. .25.
Machado-Alba
JE
, Calvo-Torres
LF
, Gaviria-Mendoza
A
, Augusto MejíA-Vélez
C
. Prescription profile of pyridostigmine use in a population of patients with myasthenia gravis
. Muscle Nerve
. 2017 Dec
;56
(6
):1041
–6
. .26.
Cea
G
, Martinez
D
, Salinas
R
, Vidal
C
, Hoffmeister
L
, Stuardo
A
. Clinical and epidemiological features of myasthenia gravis in Chilean population
. Acta Neurol Scand
. 2018 Oct
;138
(4
):338
–43
. .27.
Pallaver
F
, Riviera
AP
, Piffer
S
, Ricciardi
R
, Roni
R
, Orrico
D
, et al. Change in myasthenia gravis epidemiology in Trento, Italy, after twenty years
. Neuroepidemiology
. 2011
;36
(4
):282
–7
.28.
Heldal
AT
, Eide
GE
, Gilhus
NE
, Romi
F
. Geographical distribution of a seropositive myasthenia gravis population
. Muscle Nerve
. 2012 Jun
;45
(6
):815
–9
. .29.
Montomoli
C
, Citterio
A
, Piccolo
G
, Cioccale
R
, Ferretti
VV
, Fratti
C
, et al. Epidemiology and geographical variation of myasthenia gravis in the province of Pavia, Italy
. Neuroepidemiology
. 2012
;38
(2
):100
–5
. .30.
Lefter
S
, Hardiman
O
, Ryan
AM
. A population-based epidemiologic study of adult neuromuscular disease in the Republic of Ireland
. Neurology
. 2017 Jan 17
;88
(3
):304
–13
.31.
Hehir
MK
, Silvestri
NJ
. Generalized myasthenia gravis: classification, clinical presentation, natural history, and epidemiology
. Neurol Clin
. 2018 May
;36
(2
):253
–60
. .32.
Breiner
A
, Young
J
, Green
D
, Katzberg
HD
, Barnett
C
, Bril
V
, et al. Canadian administrative health data can identify patients with myasthenia gravis
. Neuroepidemiology
. 2015
;44
(2
):108
–13
. .33.
Poulas
K
, Tsibri
E
, Kokla
A
, Papanastasiou
D
, Tsouloufis
T
, Marinou
M
, et al. Epidemiology of seropositive myasthenia gravis in Greece
. J Neurol Neurosurg Psychiatry
. 2001 Sep
;71
(3
):352
–6
. .34.
Aragones
JM
, Altimiras
J
, Roura
P
, Alonso
F
, Bufill
E
, Munmany
A
, et al. Prevalence of myasthenia gravis in the Catalan county of Osona
. Neurologia
. 2017 Jan–Feb
;32
(1
):1
–5
.© 2021 S. Karger AG, Basel
2021
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.
