|
| Treatment | Evidence of efficacy in generalised JMG | Reference |
|
| Acetylcholinesterase inhibitors | First line therapy.May be sufficient in ocular JMG or mild generalised JMG | Skeie et al., 2010 [29] |
| Thymectomy | Recommended to increase remission rates in postpubertal, seropositive children. Not recommended in prepubertal children | Hennessey et al., 2011 [30]
Rodriguez et al., 1983 [31]
Tracy et al., 2009 [32]
Lindner et al., 1997 [20] |
| Steroids | Often used in combination with steroid sparing agents. Significant side-effect profile if used long-term at high dose | Schneider-Gold et al., 2005 Cochrane review: one JMG study, others adult or unspecified age ranges [33]
Zhang et al., 1998 [6] |
| Steroid sparing agents | | |
| Azathioprine | Usually used in combination with corticosteroids. Occasionally used alone. | Mertens et al., 1981 [34] includes some children but no subgroup analysis
Gold et al., 2008 [35]
Palace et al., 1998 [36] adult study |
| Cyclosporin A | As monotherapy or in conjunction with corticosteroids | Tindall et al., 1987 [37] adult study
Hart et al., 2009 (Cochrane) [38] series include some children |
| Cyclophosphamide | | De Feo et al., 2002 [39] adult population
Hart et al., 2009 [38] (Cochrane) series include some children |
| Tacrolimus | | Furukawa et al., 2008 [40]
Ponseti et al., 2008 [41]
both include post pubertal children
Ishigaki et al., 2009 [42] prepubertal female |
| MMF | | Hehir et al., 2010 [43] includes some peri-/postpubertal children |
| Rituximab | | Wylam et al., 2003 [44] pediatric case |
| IVIG/Plasma exchange | | Selcen et al., 2000 [45]
Gajados et al., 2008, Cochrane database [46] |
|
