Comparison of Conservative Treatment and Thymectomy on Myasthenia Gravis Outcome

Background A systematic review of the literature was performed to compare long-term outcomes of thymectomy and medical treatment for generalized myasthenia gravis (MG). Methods A Medline search through June 2015 resulted in 71 studies, 27 of which were selected (10,140 patients: 5,275 thymectomies, 4,865 medication). Results The pooled proportion of remission with thymectomy was 0.31 (95% CI, 0.25–0.37), with conservative treatment it was 0.15 (95% CI, 0.12–0.18). The odds ratio (OR) of remission with thymectomy in comparison with medication alone was 2.44 (95% CI, 1.91–3.12) overall and according to medication type and remission definitions. Conclusions Thymectomy is superior to conservative treatment with solely medication on remission in MG.