Specific attributes of myasthenia gravis patients may correlate with a higher burden of depression and anxiety: a literature review



Poster Number: M274


Louis Jackson, PharmD, Janssen Scientific Affairs, Nizar Souayah, Rutgers NJMS - Department of Medicine, Sindhu Ramchandren, Janssen R&D, LLC, Zia Choudhry, Janssen Scientific Affairs, LLC, Rachelle Rodriguez, Janssen Global Services, Commercial Data Science, Jacqueline Pesa, Janssen Scientific Affairs, LLC, Kristin Heerlein, Janssen Global Services, Medical Affairs, Kelly Gwathmey, MD, Department of Neurology, Virginia Commonwealth University School of Medicine

Background: Increased rates of depression and anxiety have been identified among patients with myasthenia gravis (MG). However, insights into the specific attributes of patients who experience a higher mental health burden are needed to improve overall outcomes for patients with MG.

Objective: To investigate whether a higher prevalence or severity of depression and anxiety is reported for specific attributes of patients with MG.

Methods: A targeted literature review examined depression and anxiety data from MG observational studies published between January 2018–December 2022.

Results: Eighteen publications were selected for inclusion capturing prospective cohort, retrospective cohort, or cross-sectional studies. Patient-reported outcome tools to quantify the severity of MG included various measures such as the MG-activities of daily living profile, while measures such as the Patient Health Questionnaire (module 9: depression) and Generalized Anxiety Disorder scale-7 were used to quantify depression/anxiety severity. Depression rates ranged from 17% to 60% (n=12 studies) in patients with MG, and anxiety rates ranged from 8% to 64% (n=7 studies). Women presented with higher rates of depression and anxiety in 3 studies, although one study found no sex-related differences. Depression (n=8 studies) and anxiety (n=7 studies) severity positively correlated with MG severity. Additionally, 5 studies noted a positive correlation between depression and fatigue severity. Single studies reported a positive relationship between depression severity and younger patients, shorter duration of MG, higher level of education, and higher income, but none reported associations with age at onset of MG or use of concomitant medications.

Conclusions: Depression severity in patients with MG is correlated with disease severity and fatigue, and disproportionately impacted patients with select attributes. Findings highlighted the substantial depression and anxiety burden among patients with MG, and the need for neurologists to take a more holistic approach when considering treatment options for their patients with MG.