Stable remissions in myasthenia gravis

Forty-two myasthenic patients received a total of 7.6 to 130 gm of cyclophosphamide over 2 to 37 months; 33 received prednisone concomitantly. Twenty-five (60%) are presently asympatomatic. Seventy-four percent improved after 1 month of therapy. Fifty-eight percent of those treated for a year, 86% of those treated for 2 years, and 100% of those treated for 32 months were asymptomatic. Based on our definition of remission (asymptomatic for at least 6 months without medication), 12 of the 16 patients (75%) followed for at least 18 months were in remission. Cyclophosphamide may have more specific therapeutic effects than other immunosuppressive drugs used to treat myasthenia.