Evidence map›Paper›PMID 41972143›Full record

ArticleFrontiers in immunology2026

Predictors of exacerbation in myasthenia gravis after minimal symptom expression: a bicenter cohort study.

Dingxian He, Hongxi Chen, Huahua Zhong, Nana Zhang, Chong Yan, Jie Song, Jianying Xi, Sushan Luo, Chongbo Zhao, Hongyu Zhou

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Dingxian He *Huashan Rare Disease Centre and Department of Neurology, Huashan Hospital, Shanghai Medical College, National Centre for Neurological Disorders, Fudan University, Shanghai, China.
Hongxi Chen *Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
Huahua ZhongHuashan Rare Disease Centre and Department of Neurology, Huashan Hospital, Shanghai Medical College, National Centre for Neurological Disorders, Fudan University, Shanghai, China.
Nana ZhangDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, China.
Chong YanHuashan Rare Disease Centre and Department of Neurology, Huashan Hospital, Shanghai Medical College, National Centre for Neurological Disorders, Fudan University, Shanghai, China.
Jie SongHuashan Rare Disease Centre and Department of Neurology, Huashan Hospital, Shanghai Medical College, National Centre for Neurological Disorders, Fudan University, Shanghai, China.
Jianying XiHuashan Rare Disease Centre and Department of Neurology, Huashan Hospital, Shanghai Medical College, National Centre for Neurological Disorders, Fudan University, Shanghai, China.
Sushan LuoHuashan Rare Disease Centre and Department of Neurology, Huashan Hospital, Shanghai Medical College, National Centre for Neurological Disorders, Fudan University, Shanghai, China.
Chongbo ZhaoHuashan Rare Disease Centre and Department of Neurology, Huashan Hospital, Shanghai Medical College, National Centre for Neurological Disorders, Fudan University, Shanghai, China.
Hongyu ZhouDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Predicting exacerbation risk in clinically treated patients with myasthenia gravis (MG) is essential for personalised intervention with neurotherapies. This study investigated whether dynamic monitoring of anti-acetylcholine receptor antibody (AChR-ab) levels could predict exacerbation in MG patients following minimal symptom expression (MSE), and developed a validated model for risk stratification to inform treatment decisions. Methods: We conducted a bicenter cohort study enrolling AChR-ab+ adult MG patients who achieved MSE. The derivation cohort included 339 patients from Huashan Hospital, and the validation cohort comprised 60 patients from West China Hospital. Exacerbation was defined as an increase of ≥ 2 points in the MG Activities of Daily Living score. Independent predictors were identified through univariate and multivariate logistic regression analyses, and a prediction model was subsequently developed and validated using discrimination and calibration metrics. Results: Longitudinal AChR-ab levels strongly correlated with disease progression, with a median time to exacerbation of 35.1 months post-MSE. Independent predictors included disease duration to MSE achievement, AChR-ab change, thymoma, comorbid immune-related diseases, and history of myasthenic crisis. The model demonstrated excellent discrimination in derivation (AUC = 0.886) and validation cohorts (AUC = 0.829), with good calibration in both datasets. Conclusion: Dynamic AChR-ab monitoring provides strong predictive value for MG exacerbation, and our validated prediction model offers clinicians a practical tool for personalized risk stratification and therapeutic decision-making in patients achieving disease stability.

Indexed as

AutoantibodiesMyasthenia GravisReceptors, CholinergicAdultAgedCohort StudiesDisease ProgressionFemaleHumansMaleMiddle AgedPrognosisAutoantibodiesReceptors, CholinergicAChR antibodyexacerbationmyasthenia gravispersonalizedprediction

Identifiers

PMID41972143
PMCPMC13066242

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.