| Author (year) | n | Study Design | Demographics | Treatment | Treatment Schedule | Confounding | Follow‐up | Blinding | OR (95% CI) |
| Papapetropoulos (2003) | 28
7 steroids
21 no steroids | Case‐control | Mean age 48.6
Range: 15 to 80
61% male | Steroids | Gradual titration to 60 mg every other day and then tapered to lowest dose required (5 to 10 mg every other day) | Adequate
Logistic regression to control for differences in age and antibody titer between the two treatment groups | Adequate
Follow‐up in 100%
Duration of follow‐up at least 8 years | Not done | 4.3 (0.6 to 25.9) |
| Mee (2003) | 34
11 steroids
23 no steroids | Case‐control | Mean age 55
Range: 18 to 87
56% male | Steroids | 25 mg per day (mean duration of therapy 33.5 months) | Adequate
Duration of ocular symptoms, duration of follow‐up and antibody titers similar between the two treatment groups | Adequate
Follow‐up in 100%.
Mean duration of follow‐up 50.5 months | Not done | 0.02 (0.001 to 0.16) |
| Kupersmith (2003) | 147
58 steroids
36 no steroids | Cohort | Mean age 50
Range 2 to 80
57% male | Steroids | 10 mg per day for 2 days, 20 mg per day for 2 days, dose increased to 50 to 60 mg per day for 4 to 5 days, 40 mg per day for 1 week, 30 mg per day for 1 week, 20 mg per day for 1 week, 10 mg/20 mg every alternate day for 1 week, dose further reduced by 2.5 mg per day each week | Adequate
Age and proportion of participants with elevated antibody titers similar between the two treatment groups | Inadequate
Follow‐up in 64%.
Mean duration of follow‐up 3.6 years (range 0.5 to 16 years) | Not done | 0.13 (0.04 to 0.45) |
| Monsul (2004) | 56
27 steroids
29 no steroids | Cohort | Mean age 53 | Steroids | 40 to 60 mg per day tapered to 2.5 to 10 mg per day over 3 to 6 months | Adequate
Age and proportion of participants with elevated antibody titers similar between the two groups | Adequate
Follow‐up in 100%.
Minimum duration of follow‐up 24 months | Not done | 0.24 (0.06 to 0.99) |
| Sommer (1997) | 78
45 steroids
33 no steroids | Cohort | Mean age 50.6
Range 10 to 84
49% male | Steroids | Maximum dose 52 mg per day (mean duration of therapy 32 months) | Inadequate
Age similar between two groups, but proportion with elevated antibody titers and with abnormal repetitive nerve stimulation different between the treatment groups | Adequate
Follow‐up in 100%.
Duration of follow‐up not specified. | Not done | 0.09 (0.03 to 0.29) |
| Kupersmith (2009) | 87 55 prednisone 32 no prednisone | Cohort | Mean age
Range 4 to 87 years
63% male | Steroids | 10 mg per day for 2 days, 20 mg per day for 2 days, dose increased to 50 to 60 mg per day for 7 days, dose decreased by 10mg per week to 10 mg per day, dose further reduced by 2.5 mg per day each week | Inadequate. Prednisone treated patients were those who did not refuse or had no contra‐indication to prednisone treatment. Gender distribution, age and frequency of elevated AChR antibodies were comparable between the two treatment groups. | Adequate
Follow‐up in 100%, but follow‐up duration not explicitly reported. | Not done | 0.15 (0.05 to 0.4) |
| Ortiz (2008) | 21 6 prednisone 15 no prednisone | Cohort | Median age 2.6
Range 1.2 ‐ 4.9 | Steroids | Not specified | Inadequate. No discussion of whether the two treatment groups were comparable with respect to important potential confounding variables. | Adequate
Follow‐up in 100%; mean duration 6.5 (range 2‐15.6) | Not done | 1.3 (0.09 to 17.7) |
| Sommer (1997) | 78
27 azathioprine
51 no azathioprine | Cohort | Mean age 50.6
Range 10 to 84
49% male | Azathioprine | Maximum dose 145 mg per day (mean duration of therapy 44 months) | Inadequate
Age similar between two groups, but proportion with elevated antibody titers and with abnormal repetitive nerve stimulation different between the treatment groups | Adequate
Follow‐up in 100%.
Duration of follow‐up not specified. | Not done | 0.18 (0.05 to 0.67) |
| Kawaguchi (2005) | 75
17 thymectomy
58 no thymectomy | Cohort | Mean age 41
Range 1 to 76
35% male | Thymectomy | | Adequate
Age, the use of concurrent immunosuppressive therapy and duration of follow‐up were similar in the two treatment groups | Adequate
Follow‐up in 100%
Duration of follow‐up ranges from 58 to 86 months | Not done | 0.23 (0.012 to 4.31) |
