• Jesús Sancho, Santos Ferrer, Antonio Quezada, Elia Gimenez, and Jaime Signes-Costa.
• Drs Sancho, Ferrer, Quezada, and Gimenez are affiliated with Respiratory Medicine Department, Hospital Clínico Universitario, Valencia, Spain; and Institute of Health Research INCLIVA, Valencia, Spain. Dr signes-costa is affiliated with Respiratory Medicine Department, Hospital Clínico Universitario, Valencia, Spain; Institute of Health Research INCLIVA, Valencia, Spain; and University of Valencia, Valencia, Spain. jesus.sancho@uv.es.
• Respir Care. 2024 Feb 28; 69 (3): 333338333-338.

BackgroundNoninvasive ventilation (NIV) plays an important role in avoiding endotracheal intubation during myasthenic crisis, yet there are few published data concerning long-term home NIV in stable out-patients with myasthenia gravis (MG). The aim of this study was to describe the prevalence of NIV in a cohort of subjects with stable MG and to analyze contributing factors that could predict the need of NIV.MethodsWe performed a cross-sectional study that included subjects diagnosed with MG managed in the respiratory care unit over the previous year. Subjects underwent clinical analysis including demographic, clinical, and functional respiratory data.ResultsOf the 50 subjects included, 35 (70%) were positive for nicotinic acetylcholine receptor antibodies, and 68% had a diagnosis of generalized MG. Bulbar symptoms developed in 16 (32%), and 10 (20%) subjects needed long-term home NIV. The only variable predicting the need for long-term NIV was MG severity measured with Myasthenia Gravis Foundation of America (MGFA), mainly grades IIB (odds ratio 0.14 [95% CI 0.02-0.85], P = .03) and IIIB (odds ratio 0.02 [95% CI 0.01-0.34], P = .01).ConclusionsHome NIV was needed in a substantial percentage of medically stable subjects with MG, mainly in those with generalized type and with oropharyngeal and/or respiratory muscle involvement (MGFA grades IIB and IIIB).Copyright © 2024 by Daedalus Enterprises.

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