Corticosteroid use in myasthenia gravis

Results: Baseline corticosteroid use was comparable between groups (belimumab, 481 [%]; placebo, 241 [%]), with most patients receiving > mg/day (%). A numerically greater proportion of patients with baseline dose > mg/day in the belimumab group had a dose reduction of ≥25% to ≤ mg/day during Weeks 40–52 compared with patients receiving placebo (belimumab, %; placebo, %; OR [95% CI] [, ]; p=). Fewer patients in the belimumab group versus the placebo group required ≥50% increase (min ≥5 mg/day) in dose during Weeks 40–52 (Week 52: belimumab, %; placebo, %; OR [95% CI] [, ]; p=) or any increase in corticosteroid from Weeks 20–28 and 36–52 (Week 52: belimumab, %; placebo, %; OR [95% CI] [, ]; p=). The percentage of patients with ≥50% reduction in corticosteroid dose by Week 52 was similar in the belimumab (range: –%) and placebo (range: 0–%) groups. A small number of patients in each group required an increase (≥50%, min ≥5 mg/day) in dose from baseline (range: belimumab –%; placebo, –%). Mean (SD) cumulative corticosteroid dose at Week 52 was mg () in the belimumab group and mg () in the placebo group; the median (IQR) was the same in both groups ( [1825–5475]; p=). Median (IQR) corticosteroid dose at baseline was 10 mg/day (IQR 5–15) in both groups; no meaningful change occurred in either group by Week 52. Mean dose at baseline was mg/day and mg/day in the belimumab and placebo groups, with mean changes at Week 52 of - mg and - mg, respectively. Adverse events incidence (≥1) was similar (belimumab, %; placebo %).

Most injections into the knee or a smaller joint, like that at the base of the thumb, are simple procedures that can be done in a doctor’s surgery. When performed by an experienced physician, the injection is only mildly uncomfortable.
First, the doctor cleans the skin in the area with an antiseptic. If the joint is puffy and filled with fluid, the doctor may insert a needle into the joint to withdraw the excess fluid and examine it. Removing the fluid rapidly relieves pain also because it reduces pressure in the joint and may speed-up healing. Next, the doctor uses a different needle to inject the corticosteroid into the joint.

Injecting a large joint, like the hip, is more complicated and may require imaging tests to help the doctor guide the needle into the joint. Experienced rheumatologists, orthopaedic surgeons, anaesthetists, and radiologists may inject the facet joints of the lower spine.

It is important to use the correct amount of topical steroid for your eczema, as instructed by your healthcare professional. Topical steroids should be applied with clean hands so that the skin just glistens. It can sometimes be difficult to judge how much steroid to use and there are guidelines on the amount required to cover body areas that are affected by eczema. These are based on the Finger Tip Unit (FTU), and explained in detail in our fact sheet which you can download as a pdf from the related documents to the right of this page.

Corticosteroid use in myasthenia gravis

corticosteroid use in myasthenia gravis


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