PMID- 27895458
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 1177-5467 (Print)
IS  - 1177-5483 (Electronic)
IS  - 1177-5467 (Linking)
VI  - 10
DP  - 2016
TI  - Clinical and imaging evaluation of the response to intravenous steroids in 
      patients with Graves' orbitopathy and analysis on who requires additional 
      therapy.
PG  - 2277-2289
AB  - OBJECTIVE: The aim of this study was to evaluate the safety and efficacy of an 
      individualized steroid regimen in patients with moderate-to-severe Graves' 
      orbitopathy (GO) by monitoring clinical and imaging parameters. METHODS: In 
      total, 47 patients with active, moderate-to-severe GO were enrolled in this 
      study. All the patients received the proposed treatment regimen by European Group 
      on GO of 4.5 g of intravenous (IV) methylprednisolone for 12 weeks. At the end of 
      the IV treatment, patients with persistent active GO (Group 1) who were assessed 
      by clinical examination and orbital imaging with short tau inversion 
      recovery-sequence magnetic resonance imaging (STIR MRI) received additional 
      treatment with oral prednisolone, and those with inactive GO (Group 2) received 
      no further treatment. RESULTS: Of the 42 patients who completed the study, 22 
      (52.4%) patients formed Group 1 and 20 (47.6%) patients Group 2. At the 12th 
      week, the overall response to IV treatment was 76.2%, and clinical activity score 
      (CAS) improvement was 69%. At the 24th week, the overall response was 92.8%, and 
      CAS improvement was 97.6%, without statistically significant difference in CAS 
      and total eye score between these two groups (P=0.157 and P=0.856, respectively). 
      Ophthalmic manifestations were improved, being absent or minimal in 78.6% of 
      patients at the 24th week follow-up. Recurrence of disease activity occurred in 
      9.5% of patients up to 24 weeks after the completion of treatment, and major 
      adverse events occurred in 6.4% of patients. CONCLUSION: In patients with 
      moderate-to-severe GO, IV steroid treatment, followed by oral treatment, when 
      needed, is an effective regimen with low rates of adverse events and recurrences. 
      STIR MRI is a significant tool for recognizing patients who need additional 
      steroid treatment.
FAU - Tsirouki, Theodora
AU  - Tsirouki T
AD  - Department of Ophthalmology, University Hospital of Larissa, Larissa.
FAU - Bargiota, Alexandra
AU  - Bargiota A
AD  - Department of Endocrinology, University Hospital of Larissa, Larissa.
FAU - Tigas, Stelios
AU  - Tigas S
AD  - Department of Endocrinology, University Hospital of Ioannina, Ioannina.
FAU - Vasileiou, Agathi
AU  - Vasileiou A
AD  - Department of Endocrinology, University Hospital of Larissa, Larissa.
FAU - Kapsalaki, Eftichia
AU  - Kapsalaki E
AD  - Department of Diagnostic Radiology, University Hospital of Larissa, Larissa.
FAU - Giotaki, Zoe
AU  - Giotaki Z
AD  - Department of Endocrinology, University Hospital of Ioannina, Ioannina.
FAU - Asproudis, Ioannis
AU  - Asproudis I
AD  - Department of Ophthalmology, University Hospital of Ioannina, Ioannina, Greece.
FAU - Tsatsoulis, Agathokles
AU  - Tsatsoulis A
AD  - Department of Endocrinology, University Hospital of Ioannina, Ioannina.
FAU - Koukoulis, Georgios
AU  - Koukoulis G
AD  - Department of Endocrinology, University Hospital of Larissa, Larissa.
FAU - Tsironi, Evangelia E
AU  - Tsironi EE
AD  - Department of Ophthalmology, University Hospital of Larissa, Larissa.
LA  - eng
PT  - Journal Article
DEP - 20161117
PL  - New Zealand
TA  - Clin Ophthalmol
JT  - Clinical ophthalmology (Auckland, N.Z.)
JID - 101321512
PMC - PMC5117874
OTO - NOTNLM
OT  - Graves' orbitopathy
OT  - MRI
OT  - glucocorticoids
OT  - magnetic resonance imaging
COIS- The authors report no conflicts of interest in this work.
EDAT- 2016/11/30 06:00
MHDA- 2016/11/30 06:01
PMCR- 2016/11/17
CRDT- 2016/11/30 06:00
PHST- 2016/11/30 06:00 [entrez]
PHST- 2016/11/30 06:00 [pubmed]
PHST- 2016/11/30 06:01 [medline]
PHST- 2016/11/17 00:00 [pmc-release]
AID - opth-10-2277 [pii]
AID - 10.2147/OPTH.S118555 [doi]
PST - epublish
SO  - Clin Ophthalmol. 2016 Nov 17;10:2277-2289. doi: 10.2147/OPTH.S118555. eCollection 
      2016.