Trusted Resources: Evidence & Education
Scientific literature and patient education texts
Efficacy and Safety of Immunosuppressive Agents for Thyroid Eye Disease
source: Ophthalmic Plastic and Reconstructive Surgery
year: 2018
authors: Strianese D
summary/abstract:Purpose:
To present an update on the efficacy and safety of immunosuppressive therapy for thyroid eye disease (TED) and to offer a general recommendation for management of TED, in light of these reports.
Methods:
Data were retrieved from a literature search on PubMed, using the following words: thyroid eye disease, immunosuppressant, corticosteroid, methotrexate, azathioprine, cyclosporine, cyclophosphamide, rituximab, etanercept, adalimumab, tocilizumab, teprotumumab, adverse effects, side effects, and complications.
Results:
Corticosteroids continue to be the primary medical therapy for TED. Recent research has offered insight into potential differences between oral corticosteroid and intravenous corticosteroid treatment regimens in terms of efficacy and side-effect profiles, which proved more favorable for the latter. The use of some traditional immunosuppressive agents, such as methotrexate and mycophenolate, seems suitable as steroid-sparing medications. In recent years, many scientific reports demonstrated the effectiveness of biologic immunosuppressive agents in the management of TED. Etanercept, adalimumab, and tocilizumab have been shown to be effective in reduction of the inflammatory signs with the possible added advantage of preventing relapse of the disease. Teprotumumab may control the disease activity, and it seems to be very effective in preventing disease progression. Infliximab might be useful in severe TED resistant to steroids and orbital decompression.
Conclusions:
Steroid therapy remains the first-line therapy for moderate/severe and severe vision-threatening TED. The biological agents may provide a deep and long-standing block of inflammatory activity in TED, with the hope to lower the risk of recurrences and to reduce the need of surgical intervention in moderate-to-severe disease. Indeed, the actual incidence of adverse effects is not yet well assessed because of the paucity of studies. Therefore, their use should be limited to those cases that really need an alternative therapy to steroids, handled by expert physician in this field.
DOI: 10.1097/IOP.0000000000001131
read more
Related Content
-
Anatomic Considerations in Thyroid Eye DiseasePurpose: To review and summarize the cl...
-
Thyroid Eye DiseaseWhat is the Thyroid Gland? Your thyroid...
-
David B. Granet, MD, FAAO, FACS, FAAPDavid B. Granet is the Anne Ratner Chair...
-
Horizon Pharma plc Announces Phase 3 Confirmatory Trial Evaluating Teprotumumab (OPTIC) for the Treatment of Active ...Horizon Pharma plc today announced topli...
-
How to Prepare for an Appointment With a TED Specialisthttps://www.youtube.com/watch?v=sKQo63E2...
-
Angels Announcer Victor Rojas Stays Strong for His Wife in Her Health BattleShe braces herself for the worst. Stayin...
-
Does Early Response to Intravenous Glucocorticoids Predict the Final Outcome in Patients With Moderate-To-Severe and...Purpose: Intravenous glucocorticoids (i...
To improve your experience on this site, we use cookies. This includes cookies essential for the basic functioning of our website, cookies for analytics purposes, and cookies enabling us to personalize site content. By clicking on 'Accept' or any content on this site, you agree that cookies can be placed. You may adjust your browser's cookie settings to suit your preferences. More Information
The cookie settings on this website are set to "allow cookies" to give you the best browsing experience possible. If you continue to use this website without changing your cookie settings or you click "Accept" below then you are consenting to this.