Consensus statement of the European Group on Graves' orbitopathy (EUGOGO) on management of GO

Bartalena, Luigi; Baldeschi, Lelio; Dickinson, A J; Eckstein, Anja; Kendall‐Taylor, P.; Marcocci, Claudio; Mourits, Maarten P.; Perros, Petros; Boboridis, Kostas; Boschi, Antonella; Currò, Nicola; Daumerie, Chantal; Kahaly, George J.; Krassas, Gerasimos E; Lane, Carol; Lazarus, John H.; Marinò, Michele; Nardi, Marco; Neoh, C; Orgiazzi, Jacques; Pearce, Simon H. S.; Pinchera, Aldo; Pitz, Susanne; Salvi, Mario; Sivelli, Paolo; Stahl, Matthias; Arx, Georg von; Wiersinga, Wilmar M.

doi:10.1530/eje-07-0666

Cited by 638 publications

(584 citation statements)

References 101 publications

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“…Oral steroid administration was the preferred dosing regimen in our institute, because it was not necessary for patients to visit the clinic once a week. 19 For severe cases, such as vision-threatening compressive optic neuropathy, intravenous steroids were given (methylprednisolone 500 mg/day for 3 days), and then substituted with the tapered oral steroid regimen.…”

Section: Subjectsmentioning

confidence: 99%

Relevance of TSH-receptor antibody levels in predicting disease course in Graves’ orbitopathy: comparison of the third-generation TBII assay and Mc4-TSI bioassay

Jang

Shin

Lee

et al. 2013

Eye

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Aims To investigate if TSH-receptor antibody (TRAb) levels measured in early Graves' orbitopathy (GO) stages are predictive of clinical disease course beyond 1 year after initial GO diagnosis and to compare performance of two newly developed TRAb assays (third-generation thyrotropin-binding inhibitor immunoglobulin (TBII) assay vs Mc4-thyroid-stimulating immunoglobulin (TSI) bioassay) in predicting disease course. Methods Newly diagnosed, untreated GO patients whose duration of ocular symptoms was less than 6 months were included. One year after initial diagnosis, all patients were classified as presenting either a mild (Group 1) or severe course (Group 2) according to their clinical manifestations. The measurements of two TRAb assays at initial GO diagnosis were used for analysis. Results Data from 112 patients were available for analysis. Seventy-three patients (65.2%) were designated as Group 1, and 39 patients (34.8%) as Group 2. Patients with higher initial TRAb levels demonstrated a higher risk of severe disease course upon multiple regression analysis (Po0.01). The cutoff values for the prediction of severe course of the third-generation TBII and Mc4-TSI assays were 10.67 IU/l and 555.10%, respectively, with assay specificities of 84.9 and 89.0%. The TBII assay predictive power

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Section: Subjectsmentioning

confidence: 99%

Relevance of TSH-receptor antibody levels in predicting disease course in Graves’ orbitopathy: comparison of the third-generation TBII assay and Mc4-TSI bioassay

Jang

Shin

Lee

et al. 2013

Eye

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“…12 Orbital decompression can restore appearance and save vision, leading to major improvements in quality of life. 9 The data presented here provide an insight into the current management of patients with Graves' orbitopathy in England.…”

Section: Discussionmentioning

confidence: 99%

“…A European consensus on the management of Graves' orbitopathy 12 recommended that patients with Graves' orbitopathy should be managed in specialist centres with appropriate experience and expertise, and this is echoed by the Amsterdam Declaration. 8 On the basis of our data on orbital decompression, England appears to fall short of this expectation.…”

Section: Discussionmentioning

confidence: 99%

Orbital decompression for Graves’ orbitopathy in England

Perros

Chandler

Dayan

et al. 2011

Eye

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Aims The purpose of this study was to obtain data on orbital decompression procedures performed in England, classed by hospital and locality, to evaluate regional variation in care. Methods Data on orbital decompression taking place in England over a 2-year period between 2007 and 2009 were derived from CHKS Ltd and analysed by the hospital and primary care trust.Results and conclusions In all, 44% of these operations took place in hospitals with an annual workload of 10 or fewer procedures. Analysis of the same data by primary care trust suggests an almost 30-fold variance in the rates of decompression performed per unit population. Expertise available to patients with Graves' orbitopathy and rates of referral for specialist care in England appears to vary significantly by geographic location. These data, along with other outcome measures, will provide a baseline by which progress can be judged.

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“…17,18 Patients typically have at least one of the following features: (i) 42 mm of upper eyelid retraction, (ii) moderate to severe soft tissue involvement, (iii) 43 mm of exophthalmos than would be expected for racial and gender variations, and (iv) diplopia. This definition is not intended to reflect disease activity, as all but the second of these criteria can persist indefinitely after all inflammation has waned.…”

Section: Moderate To Severe Tedmentioning

confidence: 99%

“…20 Treatment is most effective when given early in the course of active disease, with the literature now favouring high-dose intravenous glucocorticoid pulses for moderate to severe TED, with response rates of about 80% for parenteral treatment, as compared with about 60% for the oral route. 21 Although the parenteral route has fewer side effects than oral administration (56% and 85%, respectively), 22,23 it is nevertheless associated with significant morbidity in up to 6% of cases, and should be avoided in patients with a history of hepatic, cardiovascular or renal morbidity, uncontrolled hypertension, and diabetes. [24][25][26][27][28] The risk of serious systemic side effects appears to be dose related, being reported mainly when consecutive or alternating doses greater than 500mg have been given.…”

Section: Moderate To Severe Tedmentioning

confidence: 99%