PMID- 32649036
OWN - NLM
STAT- MEDLINE
DCOM- 20210427
LR  - 20210427
IS  - 1742-1241 (Electronic)
IS  - 1368-5031 (Linking)
VI  - 74
IP  - 11
DP  - 2020 Nov
TI  - Comparison of efficacy and safety of parenteral versus parenteral and oral 
      glucocorticoid therapy in Graves' orbitopathy.
PG  - e13608
LID - 10.1111/ijcp.13608 [doi]
AB  - BACKGROUND/AIMS: The most effective and safe treatment protocol for Graves' 
      orbitopathy (GO) needs to be further assessed. The aim of the present study was 
      to evaluate the efficacy, safety and outcome of parenteral versus parenteral and 
      oral glucocorticoid (GC) protocols in euthyroid patients with untreated and 
      active moderate to severe GO. METHODS: This was a retrospective observational 
      study in 140 patients comparing intravenous GC pulses only (IVGC group, 74 
      patients, 51 +/- 11 years) with historical controls of combined oral and 
      intravenous GC therapy (CombGC group, 66 patients, 49 +/- 10 years, P = ns). IVGC 
      therapy included infusions of 500 mg of methylprednisolone weekly for the first 
      six weeks, followed by infusions of 250 mg weekly for the remaining six weeks 
      (cumulative dose 4.5 g). CombGC therapy included 500 mg of methylprednisolone in 
      500 mL of saline solution for two alternative days, followed by oral prednisone 
      tapering dose repeated each month for the next 5 months (cumulative dose 10.2 g). 
      RESULTS: The overall success of the treatment was 43/66 (65%) in the CombGC group 
      and 37/73 (51%, P = .071) in the IVGC group. Deterioration of GO developed in 
      four (6%) patients during CombGC therapy and in nine (12%, P = .214) patients 
      during IVGC therapy. After 6 months, relapse of GO was observed in 10/37 (26%) in 
      the IVGC group, whereas none of the patients in CombGC had a relapse (P < .001). 
      There were significantly more side effects in the CombGC versus IVGC group 
      (49/66, 74% vs 28/74, 38%, P < .001). CONCLUSIONS: Our data suggest that CombGC 
      therapy was more efficient with significantly less relapse rate, but with more 
      side effects in comparison to IVGC therapy.
CI  - (c) 2020 John Wiley & Sons Ltd.
FAU - Nedeljkovic Beleslin, Biljana
AU  - Nedeljkovic Beleslin B
AUID- ORCID: 0000-0002-1687-9297
AD  - Clinic for Endocrinology, Diabetes and Metabolic Disorders, Clinical Center of 
      Serbia, Belgrade, Serbia.
AD  - Medical Faculty, University of Belgrade, Belgrade, Serbia.
FAU - Ciric, Jasmina
AU  - Ciric J
AD  - Clinic for Endocrinology, Diabetes and Metabolic Disorders, Clinical Center of 
      Serbia, Belgrade, Serbia.
AD  - Medical Faculty, University of Belgrade, Belgrade, Serbia.
FAU - Stojkovic, Mirjana
AU  - Stojkovic M
AD  - Clinic for Endocrinology, Diabetes and Metabolic Disorders, Clinical Center of 
      Serbia, Belgrade, Serbia.
AD  - Medical Faculty, University of Belgrade, Belgrade, Serbia.
FAU - Savic, Slavica
AU  - Savic S
AD  - Clinic for Endocrinology, Diabetes and Metabolic Disorders, Clinical Center of 
      Serbia, Belgrade, Serbia.
FAU - Lalic, Tijana
AU  - Lalic T
AD  - Clinic for Endocrinology, Diabetes and Metabolic Disorders, Clinical Center of 
      Serbia, Belgrade, Serbia.
FAU - Stojanovic, Milos
AU  - Stojanovic M
AD  - Clinic for Endocrinology, Diabetes and Metabolic Disorders, Clinical Center of 
      Serbia, Belgrade, Serbia.
AD  - Medical Faculty, University of Belgrade, Belgrade, Serbia.
FAU - Miletic, Marija
AU  - Miletic M
AD  - Clinic for Endocrinology, Diabetes and Metabolic Disorders, Clinical Center of 
      Serbia, Belgrade, Serbia.
AD  - Medical Faculty, University of Belgrade, Belgrade, Serbia.
FAU - Knezevic, Miroslav
AU  - Knezevic M
AD  - Medical Faculty, University of Belgrade, Belgrade, Serbia.
AD  - Clinic for Ophthalmology, Clinical Center of Serbia, Belgrade, Serbia.
FAU - Stankovic, Branislav
AU  - Stankovic B
AD  - Medical Faculty, University of Belgrade, Belgrade, Serbia.
AD  - Clinic for Ophthalmology, Clinical Center of Serbia, Belgrade, Serbia.
FAU - Zarkovic, Milos
AU  - Zarkovic M
AD  - Clinic for Endocrinology, Diabetes and Metabolic Disorders, Clinical Center of 
      Serbia, Belgrade, Serbia.
AD  - Medical Faculty, University of Belgrade, Belgrade, Serbia.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20200802
PL  - India
TA  - Int J Clin Pract
JT  - International journal of clinical practice
JID - 9712381
RN  - 0 (Glucocorticoids)
RN  - X4W7ZR7023 (Methylprednisolone)
SB  - IM
MH  - Administration, Intravenous
MH  - Glucocorticoids/adverse effects
MH  - *Graves Ophthalmopathy/drug therapy
MH  - Humans
MH  - Methylprednisolone/therapeutic use
MH  - Retrospective Studies
EDAT- 2020/07/11 06:00
MHDA- 2021/04/28 06:00
CRDT- 2020/07/11 06:00
PHST- 2020/04/16 00:00 [received]
PHST- 2020/07/06 00:00 [accepted]
PHST- 2020/07/11 06:00 [pubmed]
PHST- 2021/04/28 06:00 [medline]
PHST- 2020/07/11 06:00 [entrez]
AID - 10.1111/ijcp.13608 [doi]
PST - ppublish
SO  - Int J Clin Pract. 2020 Nov;74(11):e13608. doi: 10.1111/ijcp.13608. Epub 2020 Aug 
      2.