Álvarez Velasco, RodrigoGutiérrez Gutiérrez, GerardoTrujillo Reyes, Juan CarlosMartínez Téllez, ElisabethSegovia, SoniaArribas Velasco, MarinaFernández, GuillermoParadas, CarmenVélez Gómez, BeatrizCortés Vicente, ElenaEt al.2022-07-062022-07-062021Álvarez-Velasco, R., Gutiérrez-Gutiérrez, G., Trujillo, J. C., Martínez, E., Segovia, S., Arribas-Velasco, M., Fernández, G., Paradas, C., Vélez-Gómez, B., Casasnovas, C., Nedkova, V., Guerrero-Sola, A., Ramos-Fransi, A., Martínez-Piñeiro, A., Pardo, J., Sevilla, T., Gómez-Caravaca, M. T., López de Munain, A., Jericó, I., Pelayo-Negro, A. L., … Cortés-Vicente, E. (2021). Clinical characteristics and outcomes of thymoma-associated myasthenia gravis. European Journal of Neurology, 28(6), 2083-2091. https://doi.org/10.1111/ene.148201351-51011468-1331http://hdl.handle.net/11268/11430Background and purpose: Prognosis of myasthenia gravis (MG) in patients with thymoma is not well established. Moreover, it is not clear whether thymoma recurrence or unresectable lesions entail a worse prognosis of MG. Methods: This multicenter study was based on data from a Spanish neurologist-driven MG registry. All patients were aged >18 years at onset and had anti-acetylcholine receptor antibodies. We compared the clinical data of thymomatous and nonthymomatous patients. Prognosis of patients with recurrent or nonresectable thymomas was assessed. Results: We included 964 patients from 15 hospitals; 148 (15.4%) had thymoma-associated MG. Median follow-up time was 4.6 years. At onset, thymoma-associated MG patients were younger (52.0 vs. 60.4 years, p < 0.001), had more generalized symptoms (odds ratio [OR]: 3.02, 95% confidence interval [CI]: 1.95-4.68, p < 0.001) and more severe clinical forms according to the Myasthenia Gravis Foundation of America (MGFA) scale (OR: 1.6, 95% CI: 1.15-2.21, p = 0.005). Disease severity based on MGFA postintervention status (MGFA-PIS) was higher in thymomatous patients at 1 year, 5 years, and the end of follow-up. Treatment refractoriness and mortality were also higher (OR: 2.28, 95% CI: 1.43-3.63, p = 0.001; hazard ratio: 2.46, 95% CI: 1.47-4.14, p = 0.001). Myasthenic symptoms worsened in 13 of 27 patients with recurrences, but differences in long-term severity were not significant. Fifteen thymomatous patients had nonresectable thymomas with worse MGFA-PIS and higher mortality at the end of follow-up. Conclusions: Thymoma-associated MG patients had more severe myasthenic symptoms and worse prognosis. Thymoma recurrence was frequently associated with transient worsening of MG, but long-term prognosis did not differ from nonrecurrent thymoma. Patients with nonresectable thymoma tended to present severe forms of MG.engMiastenia gravisTimomaSignos y síntomasjournal article10.1111/ene.14820restricted accessNeurologíaEnfermedad del sistema nerviosoEfectos fisiológicos