Evaluation of the efficacy of intravenous corticotherapy in preventing exacerbation of thyroid orbitopathy in patients with Graves’ disease treated with radioactive iodine due to hyperthyroidism
Journal Title: Postępy Nauk Medycznych - Year 2012, Vol 25, Issue 11
Abstract
<b>Introduction.</b> Radioiodine treatment of thyrotoxicosis in Graves’ disease patients may lead to orbitopathy progression. Oral glucocorticoid therapy is a standard method in prevention of eye changes exacerbation. The aim of this study was to evaluate the efficacy and safety of intravenous steroid therapy in prevention of orbitopathy exacerbation after <sup>131</sup>I treatment.<br><b>Material and methods.</b> The study included 32 patients with Graves’ disease and ophthalmopathy, treated with radioiodine due to thyrotoxicosis in 2010-2011 in the Department of Endocrinology CMKP. To prevent ophthalmopathy exacerbation, 16 patients (group 1) received intravenous methylprednisolone (4 weekly infusions of 250 mg), while the remaining 16 patients (group 2) were treated with prednisone (0.3-0.5 mg per kg of body weight for 4-5 weeks with dose reduction during 8 weeks). The groups were compared before and 1 month and 1 year after <sup>131</sup>I therapy in terms of severity of orbitopathy (NOSPECS classification) and its activity (using Clinical Activity Score – CAS), serum TSH receptor antibody (TRAb), the need for additional systemic steroid therapy due to exacerbation of eye changes and the occurrence of adverse events.<br><b>Results.</b> Groups 1 and 2 did not differ significantly according to NOSPECS class, CAS, nor TRAb concentrations at baseline, after 1 month and after 1 year of treatment. In group 1, there were no side effects of corticosteroid therapy, while in group 2 two patients discontinued prednisone therapy – 1 because of depression, and 1 because of gastrointestinal disorders.<br><b>Conclusions.</b> In compare to the commonly used oral prednisone, intravenous administration of methylprednisolone seem to be equally effective in the prevention of exacerbation of orbitopathy after radioiodine therapy and carries fewer side effects.
Authors and Affiliations
Magdalena Kochman, Helena Jastrzębska, Ewa Szczepańska, Joanna Zgliczyńska-Widłak, Jadwiga Janik
Keywords
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