To determine if a low dose of cyclosporine is effective adjuvant therapy in the treatment of myasthenia gravis (MG).
We added cyclosporine-A (Cs-A) at a low dose (mean 1.95 mg/kg/day and range of 0.84-3.8 mg/kg/day) to the immunosuppressive regimen of 12 patients with severe MG and followed them for a mean period of 40 months.
A statistically significant reduction in myasthenic severity was seen after 12 months of cyclosporine therapy. Three patients went into complete remission (no medication required). A substantial and statistically significant reduction in the dose of prednisone was seen in 5 patients who were previously receiving prednisone therapy. Mild adverse effects that resolved with dose reduction were seen in 3 patients.
Preliminarily, we conclude that low-dose cyclosporine (less than 4 mg/kg/day) may be effective in myasthenia gravis with fewer adverse effects and is well tolerated for long-term therapy.