OBJECTIVES: Myasthenia gravis (MG) is a neuromuscular autoimmune disorder characterized by muscle weakness and fatigue. While the pathophysiology of MG is well-documented, the presence of comorbidities and their impact on the patients’ clinical course remains of interest and can help inform patient care. The purpose of this study was to compare the cumulative incidence and time to onset of several common comorbidities in individuals diagnosed with MG versus matched controls.

METHODS: The study utilized the National Veterans Affairs Health Care Network ‘s database. Continuously enrolled adult patients, newly diagnosed with MG between January 1999 to March 2022, were identified for the MG cohort. A 1:1 control cohort was developed, matching on key demographic characteristics and baseline Charlson Comorbidity Index (CCI) score. Both cohorts were followed until disenrollment, death, or end of the study period. The study utilized Kaplan-Meier (KM) analysis to assess 14 common comorbidities associated with MG, including anxiety, autoimmune conditions, cardiovascular disease, depression, diabetes, gastroesophageal reflux disease (GERD), glaucoma, hyperlipidemia/hypercholesterolemia, hypertension, infections, malignancy, osteoporosis, sleeping disorders, and thyroid disorders. The KM analysis compared the cumulative incidence and time to new onset of comorbidities in the follow-up period.

RESULTS: A total of 10,632 patients with MG and 10,632 matched controls were identified. Average age at MG diagnosis for the MG cohort and controls was 70.5, and 70.3 years, respectively. Patients were followed for a median follow-up of 7 years. Across all 14 comorbidities examined, patients with MG demonstrated significantly increased incidence of individual comorbidities (p<0.001) and developed new onset comorbidities significantly faster than the matched cohort (p<0.05).

CONCLUSIONS: Patients diagnosed with MG were at significant risk to develop comorbidities commonly associated with MG and the onset occurred at a faster rate compared to the non-MG cohort. These findings underscore the association between MG and an elevated risk of specific comorbidities.