Developing outcome measures of disease activity in pediatric myasthenia.

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Clinical Guidelines
Authored By
Prior DE, Cooper BA, Zhang B, Ghosh PS
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Pediatric Medicine
Neurology
Speciality
Neurology
Pediatric Medicine
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volume
63
ISSN
1097-4598
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1097-4598
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["Prior DE, Cooper BA, Zhang B, Ghosh PS","Publisher: John Wiley & Sons Country of Publication: United States NLM ID: 7803146 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-4598 (Electronic) Linking ISSN: 0148639X NLM ISO Abbreviation: Muscle Nerve Subsets: MEDLINE","Journal Article","2021-05-01","Muscle & nerve [Muscle Nerve] 2021 May; Vol. 63 (5), pp. 751-757. Date of Electronic Publication: 2021 Feb 28.","English","1097-4598","Quality of Life*, Muscle Weakness\/*diagnosis , Myasthenia Gravis\/*diagnosis , Myasthenic Syndromes, Congenital\/*diagnosis, Child ; Child, Preschool ; Disease Progression ; Female ; Humans ; Infant ; Male ; Outcome Assessment, Health Care ; Severity of Illness Index","Child, Child, Preschool, Disease Progression, Female, Humans, Infant, Male, Outcome Assessment, Health Care, Severity of Illness Index, Muscle Weakness diagnosis, Myasthenia Gravis diagnosis, Myasthenic Syndromes, Congenital diagnosis, Quality of Life","Muscle & nerve","63"]
Description
Introduction: Pediatric myasthenia encompasses juvenile myasthenia gravis (JMG) and congenital myasthenic syndrome (CMS), which are chronic disorders with fluctuating symptoms amenable to medical therapy. Disease activity and treatment response may be difficult to assess, but, unlike adults, outcome measures have not been developed in children.<br />Methods: The study was performed in children (0-18 years of age) at the neuromuscular center of a pediatric hospital over a 3-year period. Patients were recruited prospectively as part of their routine clinical care. Demographic data, diagnosis (JMG/CMS), and the following scales were recorded at each visit: Myasthenia Gravis Foundation of America (MGFA) class, Myasthenia Gravis Composite (MGC), and Pediatric Myasthenia-Quality of Life 15 (PM-QOL15).<br />Results: Thirty-three patients (24 JMG, 9 CMS) were included in the study, 22 had two or more visits. We established known-groups validity of the MGC and PM-QOL15 scores as compared with the MGFA class. To establish concurrent validity, we constructed a receiver-operating characteristic curve and calculated threshold values of MGC and PM-QOL15 with optimal sensitivity and specificity for identifying a patient with more severe (MGFA III or higher) disease. Finally, we demonstrated the concordance between the MGC and PM-QOL15 by their statistically significant positive Pearson and Spearman correlations.<br />Discussion: Our study suggests that MGC and PM-QOL15 are important disease outcome measures in pediatric myasthenia that are easy to administer and provide reliable assessment of disease activity in the clinic setting. Further studies are needed to validate their use for pediatric clinical research trials.<br /> (© 2021 Wiley Periodicals LLC.)
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