Table 1.
Demographic data of studies selected for this review
| Author/Year (period) country | Study design | Surgical total (female, male) | Medical total (female, male) | Remission | Improvement | Follow-up | Medical treatment | ||
|---|---|---|---|---|---|---|---|---|---|
| Surgical | Medical | Surgical | Medical | ||||||
| Wolfe/2016 [14] (2006–2012) 36 centers, 32 in USA |
Multicenter RCT |
66 (50,16) | 60 (39,21) | Average MG score 6.15 | Average MG score 8.99 | 3 years | Predinisone | ||
| Barnett/2014 [17] (2000–2013) Canada | Single center Retrospective Unmatched (U) matched (M) |
U- 183 (124,59) M- 49 (25, 24) |
U- 212 (89, 123) M- 49 (27, 22) |
R/MMa U-40 (22%) M−10(21%) |
R/MMa U-49 (23%) M− 3(06%) |
60 months | Prednisone | ||
| Bachmann/2009 [18] (1980–2005) Germany |
Single center Retrospective | 84 (56, 28) | 88 (50, 38) | 35 (42%) | 12 (14%) | 32 (38%) | 15 (17%) | Mean = 10 years | Pyridostigmine/azathioprine/glucocorticoids/ plasmapheresis |
| Al-Moalen/2008 [19] (1984–2006) Saudi Arabia |
Single center Retrospective | 73 (49, 24) | 23 (13, 10) | 10 (14%) | 0 | 24 (33%) | 6 (26%) | Mean = 7.2 years | Pyridostigmine/prednisolone/azathioprine |
| Tsinzerling/2007 [20] (1956–2006) Sweden |
Single center Retrospective | 261 (179,82) | 211 (105,106) | 77 (29.5%) | 32 (15%) | 139 (53%) | 142 (67%) | > 1.5 year | Azathioprine/cyclosporine/steroids |
| Kawaguchi/2007 [21] (1999–2000) Japan |
Multicenter Retrospective | 20 (10, 10) | 14 (11, 3) | 6 (30%) | 3 (21%) | 10 (50%) | 8 (57%) | 11.7 years (surgical) 7.8 years (non-surgical) |
Cholinesterase inhibitors/corticosteroids/other immunosuppressive agents |
| Werneck/2000 [22] (1973–1995) Brazil | Single center Retrospective matched | 28 (20, 8) | 28 (20, 8) | 6 (21%) | 9 (32%) | 8 (29%) | 1 (4%) | Mean Surgical = 6.3 years Non-surgical = 3.5 years |
Prednisolone/ cholinesterase Inhibitors/ immunosuppressive agents |
| Lorenzana/1999 [23] (1991–1995) Colombia |
Single center RCT | 11 (10, 1) | 18 (16, 2) | Fatigue gain 9.1 s. | Fatigue gain 2.2 s. | Strength 2.1 | Strength 0.25 | 2 years | Prednisolone/pyridostigmine/prostigmine |
| Robertson/1998 [24] (1965–1997) UK | Single center Retrospective | 22 (21,1) | 41 (27,14) | 6 (27%) | 3 (7%) | 12 (55%) | 15 (37%) | Not reported | Anticholinesterase/steroids/azathioprine/plasmapheresis |
| Evoli/1998 [25] (not informed) Italy | Single center Retrospective matched | 45 (35,10) | 20 (14,6) | 15 (33%) | 2 (10%) | Not reported | Not reported | ≥ 3 years | cholinesterase Inhibitors/ immunosuppressive Agents/corticosteroids |
| Mantegazza/1990 [26] (not informed) Italy | Multicenter Retrospective | 555 (not reported) | 313 (not reported) | 84 (15%) | 19 (6%) | 160 (29%) | 56 (18%) | Mean = 4,9 years | Glucocorticoids/imunossupressive agents/ plasmapheresis |
| Donaldson/1990 [27] (1975–1988) USA |
Single center Retrospective | 90 | 57 | 23 (26%) | 5 (9%) | 30 (33%) | 11 (19%) | Mean 8 years | Prednisolone/pyridostigmine/azathioprine/cyclophosphamide/ plasmapheresis |
| Valli/1987 [28] (1973–1985) Italy | Single center Retrospective | 63 | 28 | 22 (35%) | 2 (7%) | 28 (44%) | 19 (68%) | 2–12 years | Cholinesterase inhibitors/corticosteroids/azathioprine |
| Papatestas/1987 [29] (1951–1985) USA |
Single center Retrospective | 788 (not reported) | 1048 (not reported) | 181 (23%) | 146 (14%) | Not reported | Not reported | Not reported | Not reported |
| Assis/1987 [30] (not informed) Brazil |
Single center Retrospective | 19 (17, 2) | 14 (12, 2) | 6 (32%) | 3 (21%) | 12 (63%) | 10 (71%) | 8–24 years | Anticolinesterasic |
| Oosterhius/1981 [31] (1960–1980) The Netherlands |
Single center Retrospective | 144 | 183 | 39 (27%) | 34 (19%) | Not reported | Not reported | 10.2 years (surgical) 16.8 years (non-surgical) |
Cholinesterase inhibitors/corticosteroids/azathioprine |
| Emeryk/1976 [32] (1963–1973) Poland |
Single center Retrospective | 112 (90,22) | 75 (52,23) | 26 (23%) | 7 (9%) | 70 (62%) | 35 (47%) | Mean 3 years | Cholinesterase inhibitors |
| Buckingham/1976 [33] (?-65) USA | Single center Retrospective matched | 80 (64,16) | 80 (64,16) | 27 (34%) | 6 (7.5%) | 26 (32%) | 13 (16%) | 19.5 years (surgical) 23 years (non-surgical) |
Not reported |
| Perlo/1971 [34] (?) USA |
Multicenter Retrospective | 267 (217,50) | 417 (?) | 92 (34%) | 71 (17%) | 109 (41%) | 46 (11%) | 1–28 years | Edrophonium chloride/neostigmine |
| Total | 2911 | 2930 | |||||||
aR/MM- Remission or minimal manifestation