Correlation of Quantitative Myasthenia Gravis and Myasthenia Gravis Activities of Daily Living scales in the MGTX study

Muscle Nerve. 2020 Aug;62(2):261-266. doi: 10.1002/mus.26910. Epub 2020 Jun 4.

Abstract

Introduction: Quantitative Myasthenia Gravis (QMG) and Myasthenia Gravis Activities of Daily Living (MG-ADL) scales were compared using the data from the Thymectomy Trial in Non-Thymomatous Myasthenia Gravis Patients Receiving Prednisone Therapy (MGTX) study.

Methods: Correlation between QMG and MG-ADL raw and change-from-baseline scores was calculated every 3 months for 60 months based on treatment groups and minimal manifestation status (MMS).

Results: QMG and MG-ADL change-from-baseline scores correlated significantly, with increasing strength of correlation over time, in both treatment groups. QMG and MG-ADL raw scores correlated significantly in both treatment groups, with increasing correlation only in the prednisone-alone group. Correlation between raw scores was weaker in patients who were in MMS, demonstrating a "floor effect" on the MG-ADL scale. Raw QMG scores could be modeled assuming a normal distribution, whereas raw MG-ADL scores could not be modeled this way.

Discussion: The floor effect and skewed distribution of the MG-ADL measure should be taken into account in the design of myasthenia gravis clinical trials.

Keywords: MG-ADL; MGTX; QMG; myasthenia gravis; outcome measure; trial design.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living*
  • Combined Modality Therapy
  • Glucocorticoids / therapeutic use
  • Humans
  • Myasthenia Gravis / physiopathology*
  • Myasthenia Gravis / therapy
  • Outcome Assessment, Health Care*
  • Prednisone / therapeutic use
  • Randomized Controlled Trials as Topic
  • Thymectomy

Substances

  • Glucocorticoids
  • Prednisone