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Randomized Trial of Thymectomy in Myasthenia Gravis

A small international prospective randomized trial of extended thymectomy with steroids vs steroids for 126 with class II to IV myasthenia gravis.  The selection criteria and powering were altered mid-trial. Surgery was associated with a better symptom score, lower dose of predisone, less use of immunosuppresives, and fewer hospitalizations at 3 years.  The positive outcomes are of surgical relevance as they may lead to a considerable increase of referrals for OPEN thymectomies! I assume that longer term outcomes will be forthcoming.

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