{"doi":"10.1002/acn3.51746","title":"Comparison between mono‐tacrolimus and mono‐glucocorticoid in the treatment of myasthenia gravis","abstract":"OBJECTIVE: Use of tacrolimus in mild to moderate myasthenia gravis (MG) is generally limited to glucocorticoid-refractory cases; the advantage of mono-tacrolimus over mono-glucocorticoids is unknown. METHODS: We included mild to moderate MG patients treated with mono-tacrolimus (mono-TAC) or mono-glucocorticoids (mono-GC). The correlation between the immunotherapy options and the treatment efficacy and side effects were examined in 1:1 propensity-score matching. The main outcome was time to minimal manifestations status or better (MMS or better). Secondary outcomes include time to relapse, the mean changes in Myasthenia Gravis-specific Activities of Daily Living (MG-ADL) scores and the rate of adverse events. RESULTS: Baseline characteristics showed no difference between matched groups (49 matched pairs). There were no differences in median time to MMS or better between the mono-TAC group and mono-GC group (5.1 vs. 2.8 months: unadjusted hazard ratio [HR], 0.73; 95% CI, 0.46-1.16; p = 0.180), as well as in median time to relapse (data unavailable for the mono-TAC group since 44 of 49 [89.8%] participants remained in MMS or better; 39.7 months in mono-GC group: unadjusted HR, 0.67; 95% CI, 0.23-1.97; p = 0.464). Changes in MG-ADL scores between the two groups were similar (mean differences, 0.3; 95% CI, -0.4 to 1.0; p = 0.462). The rate of adverse events was lower in the mono-TAC group compared to the mono-GC group (24.5% vs. 55.1%, p = 0.002). INTERPRETATION: Mono-tacrolimus performs superior tolerability with non-inferior efficacy compared to mono-glucocorticoids in mild to moderate myasthenia gravis patients who refuse or have a contraindication to glucocorticoids.","journal":"Annals of Clinical and Translational Neurology","year":2023,"id":347461,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":11,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9585,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":257250,"name":"Lin Lei","orcid":null,"position":1,"is_corresponding":false},{"id":1088922,"name":"Shengyao Su","orcid":"0000-0002-5020-7056","position":2,"is_corresponding":false},{"id":1088923,"name":"Shu Zhang","orcid":"0000-0001-8470-9727","position":3,"is_corresponding":false},{"id":1088924,"name":"Nairong Xie","orcid":"0009-0008-4616-2861","position":4,"is_corresponding":false},{"id":1088925,"name":"Ling Li","orcid":"0000-0002-0977-3822","position":5,"is_corresponding":false},{"id":1088926,"name":"Yan Lü","orcid":"0000-0001-5353-4362","position":6,"is_corresponding":false},{"id":451056,"name":"Li Di","orcid":"0000-0001-6117-9022","position":7,"is_corresponding":false},{"id":1088927,"name":"Min Wang","orcid":"0000-0001-6706-3418","position":8,"is_corresponding":false},{"id":683383,"name":"Min Xu","orcid":"0000-0002-0982-057X","position":9,"is_corresponding":false},{"id":451055,"name":"Xin‐Ming Shen","orcid":"0000-0002-7087-5166","position":10,"is_corresponding":false},{"id":1088928,"name":"Yuwei Da","orcid":"0000-0002-0318-148X","position":11,"is_corresponding":false},{"id":1088921,"name":"Zhirong Fan","orcid":"0000-0002-3118-9016","position":0,"is_corresponding":true}],"reference_count":29,"raw_metadata":null,"created_at":"2026-07-19T01:11:57.720122Z","pmid":"36808840","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}