Trusted Resources: Evidence & Education
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Meta-Analysis of Methylprednisolone Pulse Therapy for Graves’ Ophthalmopathy
source: Clinical & Experimental Ophthalmology
year: 2014
authors: Gao G, Dai J, Qian Y, Ma F
summary/abstract:A meta-analysis was performed to evaluate the efficacy of methylprednisolone pulse therapy for Graves’ ophthalmopathy. Eight studies involving 376 patients were included. A higher effective rate was found for patients treated with intravenous glucocorticoids (IVGC) over oral glucocorticoids (OGC) (risk ratio [RR] = 1.48; 95% confidence interval [CI] = 1.18-1.86). The combined IVGC and orbital radiotherapy (OR) was markedly more effective than OGC+OR (RR = 1.40; 95% CI = 1.11-1.77). IVGC resulted in an obvious reduction of clinical activity score (CAS) compared with OGC, with a weighted mean difference (WMD) of 0.86 (95% CI = 0.53-1.18). The WMD for the reduction of the CAS between IVGC+OR and OGC+OR was 0.66 (95% CI = 0.30-1.02).
IVGC is an effective treatment and cause fewer adverse events. Limiting the total cumulative dose of methylprednisolone, careful patient selection and monitoring the condition of patients during treatment are necessary.
organization: Eye and ENT Hospital Affiliated with Fudan University, China; Ministry of Health PR China, ChinaDOI: 10.1111/ceo.12317
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