Health
Thymectomy Safety in Myasthenia Gravis Treatment Highlighted in New Opinion Piece
A recent opinion piece published in Neurology sheds light on the safety of thymectomy in the treatment of myasthenia gravis, led by Gil I. Wolfe, a SUNY Distinguished Professor and the Irvin and Rosemary Smith Professor at the University at Buffalo‘s Jacobs School of Medicine and Biomedical Sciences.
The first-ever randomized study in 2016 confirmed the benefits of thymectomy, with an extension study in 2019 showing long-lasting positive outcomes in MG patients without a chest tumor, all published in The Lancet Neurology.
However, a 2023 New England Journal of Medicine paper raised concerns about thymic removal, prompting a response by clinicians and a subsequent opinion piece titled «» in the journal Neurology.
The opinion piece aimed to address the questions raised by the recent NEJM paper and underline the safety record of thymectomy in the context of myasthenia gravis treatment.
Thymectomy is primarily therapeutic, required either in the presence of a tumor like thymoma or as a treatment for MG, and differs from thymus removal commonly done during cardiac surgeries to clear the surgical field and believed to be of little importance by middle age.
According to the authors, the thymus gland plays a crucial role in training T cells to distinguish foreign invaders, with its dysfunction leading to autoimmunity in diseases like myasthenia gravis.
Key findings show that thymectomy significantly improves outcomes in MG, reducing medication needs, hospitalizations, and rescue therapies compared to medication alone, with over 80 years of successful application supported by rigorous controlled clinical trials.
The study’s co-authors include experts from institutions such as George Washington University, University of Alabama at Birmingham, Sorbonne University, and Harvard Medical School, with contributions from Yaron Perry, a clinical professor and chief of the Division of Thoracic Surgery at UB.
