The Myasthenia Gravis Status and Treatment Intensity (MGSTI) describes the post-intervention status and type of therapy required.
Parameters:
(1) symptom status
(2) treatment location
(3) level of immunotherapy needed
|
Symptom Status
|
Treatment Location
|
Level of Therapy Required
|
Level
|
|
present
|
hospital
|
IV immunoglobulin and/or plasma-pheresis within past 3 months
|
6
|
|
present
|
outpatient
|
IV immunoglobulin and/or plasma-pheresis (within past 3 months)
|
5
|
|
present
|
outpatient
|
oral therapy only
|
4
|
|
minimal (MM/PR)
|
outpatient
|
dual therapy with one or both high dose
|
3
|
|
minimal (MM/PR)
|
outpatient
|
(dual therapy, both low dose) OR (predisone mono-therapy 5 to 20 mg per day)
|
2
|
|
minimal (MM/PR)
|
outpatient
|
low dose mono-therapy (if prednisone <= 5 mg/day)
|
1
|
|
absent
|
NA
|
none
|
0 (complete stable remission)
|
where:
• MM/PR = minimal manifestations, pharmacologic remission
Therapy "low" dose:
(1) prednisone < 20 mg per day (> 4 months)
(2) mycophenolate mofetil < 2,000 mg per day (> 12 months)
(3) azathioprine < 150 mg per day (> 12 months)
(4) methotrexate < 15 mg per week (> 12 months)
(5) tacrolimus < 5 mg per day (> 6 months)
Therapy "high" dose:
(1) prednisone >= 20 mg per day (> 4 months)
(2) mycophenolate mofetil >= 2,000 mg per day (> 12 months)
(3) azathioprine >= 150 mg per day (> 12 months)
(4) methotrexate >= 15 mg per week (> 12 months)
(5) tacrolimus >= 5 mg per day (> 6 months)
