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Peer-reviewedCC BY 4.0Frontiers in Immunology

Comparison between mono-tacrolimus and mono-prednisone in the treatment of ocular myasthenia gravis: a retrospective, observational cohort study

  • Ziling Wang1,2,3
  • Jinna Li4
  • Zhelu Fan5
  • Luyang Ma1,2,3
  • Jing Ma1,2,3
  • Huiqiu Zhang1,2,3
  • Menghan Su1,2,3
  • Dan Liu1,2
  • Huifen Wang1,2,3
  • Juan Wang1,2
  • Xueli Chang1,2
  • Junhong Guo1,2
1 more authors
  • Wei Zhang1
5 affiliations
  1. 1Department of Neurology, First Hospital of Shanxi Medical University
  2. 2Research Center for Neurological Diseases, Shanxi Medical University
  3. 3First Clinical Medical College, Shanxi Medical University
  4. 4Department of Neurology, Jincheng People’s Hospital
  5. 5Department of Anesthesiology, First Hospital of Shanxi Medical University
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Abstract

Objective: The use of tacrolimus (TAC) in ocular myasthenia gravis (OMG) is generally reserved for cases refractory to prednisone (PRED); however, the advantage of monotherapy with tacrolimus (mono-TAC) over monotherapy with PRED (mono-PRED) remains unknown. The present study aimed to compare the efficacy and safety of mono-TAC and mono-PRED in OMG.

Methods: This single-center, retrospective study analyzed collected data from adult patients with treatment-naive newly diagnosed OMG who received either mono-TAC or mono-PRED. The primary outcome was the time to reach minimum symptom expression (MSE, defined as MG-ADL ≤ 1), with time to MG-ADL score of 0 as an exploratory endpoint. Secondary outcomes included the mean changes in Myasthenia Gravis Activities of Daily Living (MG-ADL) and ocular Quantitative Myasthenia Gravis (O-QMG) scores from baseline to months 1, 6, and 12 after treatment, respectively, as well as the monotherapy retention rates at month 12 in the two groups. Safety was assessed based on medical records during the hospitalization to monitor the adverse events.

Results: Forty-two patients were enrolled (mono-TAC: n = 27; mono-PRED: n = 15). For the primary outcome, the median time to MSE was 6.0 months (95% CI: 2.523-9.477) for PRED vs. 12.0 months (95% CI: 8.342-15.658) for TAC, with no significant difference between groups (log-rank P = 0.253). The exploratory endpoint of MG-ADL = 0 also showed comparable results between groups (P = 0.928). Secondary outcomes showed no significant differences in the mean changes in MG-ADL and O-QMG scores from baseline to 1, 6, and 12 months post-treatment (all P > 0.05). The monotherapy retention rates were similar (TAC: 81.5% vs. PRED: 73.3%, P = 0.698). Both treatments showed favorable safety profiles.

Conclusion: In conclusion, no statistically significant difference was observed in treatment response between tacrolimus and prednisone.

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Cite

BibTeXRIS
BibTeX
@article{wang2026comparison,
  title = {{Comparison between mono-tacrolimus and mono-prednisone in the treatment of ocular myasthenia gravis: a retrospective, observational cohort study}},
  author = {Ziling Wang and Jinna Li and Zhelu Fan and Luyang Ma and Jing Ma and Huiqiu Zhang and Menghan Su and Dan Liu and Huifen Wang and Juan Wang and Xueli Chang and Junhong Guo and Wei Zhang},
  journal = {Frontiers in Immunology},
  year = {2026},
  month = oct,
  doi = {10.3389/fimmu.2026.1917837},
  url = {https://www.frontiersin.org/articles/10.3389/fimmu.2026.1917837/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Comparison between mono-tacrolimus and mono-prednisone in the treatment of ocular myasthenia gravis: a retrospective, observational cohort study
AU  - Ziling Wang
AU  - Jinna Li
AU  - Zhelu Fan
AU  - Luyang Ma
AU  - Jing Ma
AU  - Huiqiu Zhang
AU  - Menghan Su
AU  - Dan Liu
AU  - Huifen Wang
AU  - Juan Wang
AU  - Xueli Chang
AU  - Junhong Guo
AU  - Wei Zhang
PY  - 2026
DA  - 2026/10/13
JO  - Frontiers in Immunology
DO  - 10.3389/fimmu.2026.1917837
UR  - https://www.frontiersin.org/articles/10.3389/fimmu.2026.1917837/full
AB  - Objective: The use of tacrolimus (TAC) in ocular myasthenia gravis (OMG) is generally reserved for cases refractory to prednisone (PRED); however, the advantage of monotherapy with tacrolimus (mono-TAC) over monotherapy with PRED (mono-PRED) remains unknown. The present study aimed to compare the efficacy and safety of mono-TAC and mono-PRED in OMG.  Methods: This single-center, retrospective study analyzed collected data from adult patients with treatment-naive newly diagnosed OMG who received either mono-TAC or mono-PRED. The primary outcome was the time to reach minimum symptom expression (MSE, defined as MG-ADL ≤ 1), with time to MG-ADL score of 0 as an exploratory endpoint. Secondary outcomes included the mean changes in Myasthenia Gravis Activities of Daily Living (MG-ADL) and ocular Quantitative Myasthenia Gravis (O-QMG) scores from baseline to months 1, 6, and 12 after treatment, respectively, as well as the monotherapy retention rates at month 12 in the two groups. Safety was assessed based on medical records during the hospitalization to monitor the adverse events.  Results: Forty-two patients were enrolled (mono-TAC: n = 27; mono-PRED: n = 15). For the primary outcome, the median time to MSE was 6.0 months (95% CI: 2.523-9.477) for PRED vs. 12.0 months (95% CI: 8.342-15.658) for TAC, with no significant difference between groups (log-rank P = 0.253). The exploratory endpoint of MG-ADL = 0 also showed comparable results between groups (P = 0.928). Secondary outcomes showed no significant differences in the mean changes in MG-ADL and O-QMG scores from baseline to 1, 6, and 12 months post-treatment (all P > 0.05). The monotherapy retention rates were similar (TAC: 81.5% vs. PRED: 73.3%, P = 0.698). Both treatments showed favorable safety profiles.  Conclusion: In conclusion, no statistically significant difference was observed in treatment response between tacrolimus and prednisone.
SN  - 1664-3224
ER  -