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12.09.2023 | Original Paper

Comparison of the efficacy of two different glucocorticoid regimens for treatment of active moderate-to-severe Graves’ orbitopathy

verfasst von: Mariya Asenova Stoynova, Alexander Dimitrov Shinkov, Inna Dimitrova Dimitrova, Inna Angelova Yankova, Roussanka Dimitrova Kovatcheva

Erschienen in: International Ophthalmology | Ausgabe 12/2023

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Abstract

Purpose

Intravenous glucocorticoids (GCs) are the mainstay of treatment for severe forms of Graves’ orbitopathy (GO). Our aim was to assess the effectiveness and safety of a modified monthly regimen (mMR) and to compare them with those of the established weekly regimen (WR).

Methods

This was a prospective non-randomized single-center study involving 62 patients, divided into two therapeutic groups depending on their referral time. Thirty-one subjects, admitted in the period 2017–2018, were treated with mMR, total dose—5.5 g, with intake of oral GCs after completion of intravenous infusions. Thirty subjects, who were referred in the period 2019–2020, were treated with WR, total dose—4.5 g One patient refused to be part of the WR group and was treated with mMR. Eye status and therapeutic response were evaluated on the 1st, 3rd and 6th months, quality of life—at 3rd and 6th month.

Results

At 1st month and 3rd month, there was no significant difference in the therapeutic response between the two groups. At 3rd month, the proportion of patients with improvement in soft tissue manifestations and subjective complaints was significantly higher in mMR group (65.6% vs. 40% and 81.3% vs. 46.7%, respectively) and the same manifestations were of significantly milder degree.

At 3rd month, significant improvement in quality of life was found without significant difference between the two groups.

At 6th month, worsening of GO occurred in 3 patients from WR group, while in 5 patients from mMR group further improvement was found.

Conclusions

The two GC regimens have comparable efficacy with small differences in the time of onset of the effect and its duration, as well as in the effectiveness on some ocular manifestations.

Trial registration number NCT05793359/29.03.2023, retrospectively registered..

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Titel: Comparison of the efficacy of two different glucocorticoid regimens for treatment of active moderate-to-severe Graves’ orbitopathy
verfasst von: Mariya Asenova Stoynova
Alexander Dimitrov Shinkov
Inna Dimitrova Dimitrova
Inna Angelova Yankova
Roussanka Dimitrova Kovatcheva
Publikationsdatum: 12.09.2023
Verlag: Springer Netherlands
Erschienen in: International Ophthalmology / Ausgabe 12/2023
Print ISSN: 0165-5701
Elektronische ISSN: 1573-2630
DOI: https://doi.org/10.1007/s10792-023-02875-z

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Abstract

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