Constructing and Validating a Nomogram Model for Short-Term Prognosis of Patients with AChR-Ab+ GMG

Feng Liang; Zhaoxu Yin; Yaqian Li; Guanxi Li; Jing Ma; Huiqiu Zhang; Xiaoqian Xia; Make Yao; Xiaomin Pang; Juan Wang; Xueli Chang; Junhong Guo; Wei Zhang

doi:10.1007/s40120-024-00590-0

Constructing and Validating a Nomogram Model for Short-Term Prognosis of Patients with AChR-Ab+ GMG

Neurol Ther. 2024 Mar 1. doi: 10.1007/s40120-024-00590-0. Online ahead of print.

Authors

Feng Liang^{1

2}, Zhaoxu Yin³, Yaqian Li^{1

2}, Guanxi Li^{1

2}, Jing Ma^{1

2}, Huiqiu Zhang^{1

2}, Xiaoqian Xia², Make Yao⁴, Xiaomin Pang¹, Juan Wang¹, Xueli Chang¹, Junhong Guo¹, Wei Zhang⁵

Affiliations

¹ Department of Neurology, The First Hospital of Shanxi Medical University, No. 85, Jiefang South Street, Taiyuan, China.
² First Clinical Medical College, Shanxi Medical University, Taiyuan, China.
³ Department of Neurology, Taiyuan City Central Hospital, Taiyuan, China.
⁴ Shanxi Medical University, Taiyuan, China.
⁵ Department of Neurology, The First Hospital of Shanxi Medical University, No. 85, Jiefang South Street, Taiyuan, China. zhangvey@126.com.

PMID: 38427273
DOI: 10.1007/s40120-024-00590-0

Abstract

Objective: This study aimed to establish and validate a nomogram prognostic model for predicting short-term efficacy of acetylcholine receptor antibody-positive (AChR-Ab+) generalized myasthenia gravis (GMG).

Methods: A retrospective observational study was conducted at the First Hospital of Shanxi Medical University, enrolling patients diagnosed with AChR-Ab+ GMG from May 2020 to September 2022. The primary outcome was the change in the Myasthenia Gravis Foundation of America (MGFA) post-intervention status after 6 months of standard treatment. Predictive factors were identified through univariate and multivariate logistic regression analyses, with significant factors incorporated into the nomogram. The bootstrap test was used for internal validation of the nomogram model. Model performance was assessed using calibration curves, receiver-operating characteristic curve analysis, and decision curve analysis (DCA).

Results: A total of 90 patients were enrolled, of whom 30 achieved unchanged or worse status after 6 months of standard therapy. Univariate logistic regression analysis showed that quantitative myasthenia gravis score, gender, body mass index, course of disease, hemoglobin levels, and white blood cell counts were six potential predictors. These factors were used for multivariate logistic regression analysis, and a nomogram was constructed. The calibration curve showed that the predicted value was in good agreement with the actual value (p = 0.707), and the area under the curve value (0.792, 95% CI 0.686-0.899) indicated good discrimination ability. DCA suggests that this model has potential clinical application value.

Conclusion: The constructed nomogram, based on key patient indicators, shows promise as a clinically useful tool for predicting the short-term efficacy of treatment of AChR-Ab+ GMG. Validation in larger, multicenter cohorts is needed to further substantiate its applicability.

Keywords: Acetylcholine receptor antibody; Autoimmune diseases; Myasthenia gravis; Nomogram prognostic model; Short-term treatment efficacy.