Optimization of the treatment of moderate to severe and active thyroid orbitopathy considering the recommendations of the European Group on Graves’ Orbitopathy (EUGOGO) [Optymalizacja leczenia umiarkowanej do ciężkiej i aktywnej orbitopatii tarczycowej z uwzględnieniem zaleceń European Group on Graves’ Orbitopathy (EUGOGO)]

Nowak, Mariusz; Marek, Bogdan; Kos–Kudła, Beata; Siemińśka, Lucyna; Londzin-Olesik, Magdalena; Głogowska-Szeląg, Joanna; Nowak, Wojciech; Kajdaniuk, Dariusz

doi:10.5603/ep.a2022.0040

Cited by 8 publications

(4 citation statements)

References 101 publications

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“…However, GCs are effective in only 45-80% of patients, with a high probability of disease relapse (10-40%) [1,2]. According to current guidelines, the use of tocilizumab (TCZ), a monoclonal antibody against interleukin 6 (IL-6) receptor, has been proposed as on of the second-line therapies [1][2][3].…”

Section: Clinical Vignettementioning

confidence: 99%

Long-term remission of corticosteroid-resistant Graves’ orbitopathy after therapy with tocilizumab

Rymuza,

Kuś,

Białas-Niedziela

et al. 2024

Endokrynol Pol

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Section: Clinical Vignettementioning

confidence: 99%

Long-term remission of corticosteroid-resistant Graves’ orbitopathy after therapy with tocilizumab

Rymuza,

Kuś,

Białas-Niedziela

et al. 2024

Endokrynol Pol

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“…In turn, intravenous glucocorticoid pulse therapy ( iv GCs) in monotherapy or combined with mycophenolate sodium is considered the first‐line treatment for moderate-to-severe and active GO. The EUGOGO protocol recommends a total cumulative dose of 4.5 g methylprednisolone, given in 12 weekly infusions (0.5 g/week for six weeks, followed by 0.25 g/week for six weeks) [ 13 , 14 ]. Although effective, this treatment may be accompanied by various adverse events (AEs), such as flushing, hypertension, hyperglycemia, arrhythmias, liver dysfunction, psychosis and infection [ 10 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Safety of non-standard regimen of systemic steroid therapy in patients with Graves’ orbitopathy: a single-centre experience

Sawicka-Gutaj,

Gruszczyński,

Zawalna

et al. 2024

Pharmacol. Rep

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Background Graves’ orbitopathy (GO) is an autoimmune disorder of the orbit and retro-ocular tissues and the primary extrathyroidal manifestation of Graves’ disease. In moderate-to-severe and active GO iv glucocorticoids (GCs) are recommended as first-line treatment. The aim was to assess the safety profile of methylprednisolone administered intravenously for three consecutive days at 1 g in patients with active, moderate-to-severe or sight-threatening Graves’ orbitopathy. Methods We retrospectively evaluated 161 medical records of patients with GO treated with high-dose systemic GCs in the Department of Endocrinology, Metabolic Disorders, and Internal Medicine in Poznań between 2014 and 2021. Clinical data included age, gender, laboratory results, activity and severity of GO, smoking status, disease duration, and presented side effects. Results The presence of mild side effects was observed during 114 (71%) hospitalizations. The most common complications were hyperglycemia (n = 95) and elevated aminotransferases (n = 31). Increased levels of aminotransferases were more likely observed in smokers and GO duration above 12 months. Based on the multivariate logistic regression, higher TRAb and CAS values were significantly associated with lower odds of hyperglycemia. In turn, the increased odds of elevated aminotransferases were significantly correlated with higher initial ALT levels, female gender, and GO duration above 12 months. In addition, the multidimensional correspondence analysis (MPA) showed that GO patients who declared smoking and had not l-ornithine l-aspartate applied demonstrated a higher probability of elevated aminotransferases. Conclusions Active GO treatment with high-dose systemic GCs is not associated with serious side effects. Hyperglycemia is the most common steroid-induced complication.

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“…The diagnosis of TO with the coexistence of thyroid dysfunction, the presence of antibodies to the receptor for TSH (TRAb), and bilateral but not necessarily symmetrical development of orbital symptoms is usually not difficult, and the cooperation of the endocrinologist and ophthalmologist is reduced to the assessment of the presence and differentiation of TO symptoms [2]. Diagnostic problems can be presented by cases of unilateral TO, unilateral or bilateral TO in patients…”

Section: Introductionmentioning

confidence: 99%

Differential diagnosis of thyroid orbitopathy — diseases mimicking the presentation or activity of thyroid orbitopathy

Nowak,

Marek

et al. 2024

Endokrynol Pol

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with no previous or concomitant symptoms of thyroid disorders, lack of symptoms of eyelid retraction, divergent strabismus, diplopia as the only symptom of the disease, and a history of increasing diplopia at the end of the day.The inflammatory activity and severity of TO should be diagnosed based on personal experience and according to standard diagnostic criteria. Assessment of TO inflammatory activity can be performed using the clinical activity score (CAS). Magnetic resonance imaging (MRI) is not necessary to diagnose typical cases of TO but may be necessary to assess the inflammatory activity of TO, especially in those with a so-called "posterior" course. Orbital MRI is indicated in patients with unilateral or highly asymmetric exophthalmos, suspected optic nerve neuropathy, and TO with euthyroidism, while computed tomography (CT) of the orbit is par-

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Cited by 8 publications

References 101 publications

Long-term remission of corticosteroid-resistant Graves’ orbitopathy after therapy with tocilizumab

Long-term remission of corticosteroid-resistant Graves’ orbitopathy after therapy with tocilizumab

Safety of non-standard regimen of systemic steroid therapy in patients with Graves’ orbitopathy: a single-centre experience

Differential diagnosis of thyroid orbitopathy — diseases mimicking the presentation or activity of thyroid orbitopathy

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