Determinants of Quality of Life in Myasthenia Gravis Patients

Abstract

<b>Background:</b> Although approximately half of myasthenia gravis (MG) patents achieve remission, for the remaining group MG is often a life-long disease. Better understanding of the determinants of Quality of Life (QoL) in MG is needed to optimize treatment goals in chronic cases. <b>Materials and Methods:</b> We performed a single center cross-sectional study in 339 MG adult patients (64.9% women), with ocular or generalized disease. SF-36 and a structured questionnaire was administered, including information on previous and current MG severity, medications, comorbidities, education, occupation and BMI of the patient. Mean disease duration was 7.5 + 9.3 years. Current age was 51.6 + 18.3 years, 55% had Early-Onset (<50 years) MG. <b>Results:</b> There were no statistically significant differences in mean SF-36 subscores between women and men. Worse MGFA class was related to lower QoL in physical (PCS) and mental (MCS) subscore (<i>p</i> = 0.000 for both). Patients with MGFA I-II class had significantly better QoL in physical and mental subscores than patients with more severe MG (<i>p</i> < 0.005). Late-onset MG patients had worse QoL than EOMG in physical score domain PCS (<i>p</i> = 0.049). Overweight and obese patients had lower PCS (<i>p</i> = 0.002) and MCS (<i>p</i> = 0.038) than patients with normal BMI. University education was related to statistically higher PCS (<i>p</i> = 0.015) and MCS (<i>p</i> = 0.006). QoL in currently employed was better in PCS and MCS (<i>p</i> = 0.000), with white collar workers reporting higher PCS (<i>p</i> = 0.049) than the remaining group. Patients living with family evaluated their MCS (<i>p</i> = 0.015) better than living alone. Moderate physical activity (twice a week) improved PCS (<i>p</i> = 0.045). <b>Conclusion:</b> Our study confirmed that greater severity of symptoms, age, age of onset but also BMI, type of work, education status and physical activity affect QoL in MG.