Safety And Efficacy Of Tofacitinib In Patients With Refractory Myasthenia Gravis: A Pilot Study
Safety And Efficacy Of Tofacitinib In Patients With Refractory Myasthenia Gravis: A Pilot Study
This is a 5 month study that will evaluate the efficacy of 5mg tofacitinib tablet taken twice
 a day in patients with refractory myasthenia gravis. Five adult participants with
 acetylcholine receptor antibodies will receive a four month treatment of tofacitinib followed
 by elution for one month.
Inclusion Criteria:

 -  fluctuating muscle weakness and fatigability classified as the Myasthenia Gravis
 Foundation of America (MGFA) clinical classification Type IIa-IVa;

 -  more than 10% amplitude decrement in low frequency repetitive nerve stimulation,less
 than 10% amplitude increment in high frequency repetitive nerve stimulation;

 -  anti-AChR antibody positivity;

 -  understanding and assigning the informed consent form, and having a good compliance
 with treatment.

 meet all of the criteria in above as well as at least one of the below:

 -  refractory: insufficient response to full dose- and course- steroids treatment
 (0.75-1mg per kg per day for at least 3-6 months), failure to respond adequately to
 tacrolimus (no less than 3mg per day) for 3 months;

 -  severe or intolerable adverse effects from conventional immunosuppressive therapy.

 Exclusion Criteria:

 -  a tumor history except for thymoma;

 -  a history of Type B and Type C hepatitis;

 -  a history of tuberculosis or T-SPOT.TB tset positivity;

 -  hepatic, renal and cardial insufficiency (baseline: ALT/AST>50U/L;BNP>200pg/ml）;

 -  severe allergy or infection, or chronic or recurrent infection;

 -  pregnancy;

 -  hyperlipidemia;

 -  participating other clinical trials