Trusted Resources: Evidence & Education
Scientific literature and patient education texts
Therapy of Endocrine Disease: Endocrine Dilemma: Management of Graves’ Orbitopathy
source: European Journal of Endocrinology / European Federation of Endocrine Societies
authors: Campi I, Vannucchi G, Salvi Msummary/abstract:
Management of Graves’ orbitopathy (GO) must be based on the correct assessment of activity and severity of the disease. Activity is usually assessed with the Clinical Activity Score, whereas severity is classified according to a European Group On Graves’ Orbitopathy (EUGOGO) consensus statement as mild, moderate-to-severe, and sight-threatening. Myopathic and chronic congestive forms are uncommon clinical presentations of GO. Restoration and maintenance of stable euthyroidism are recommended in the presence of GO.
In moderate-to-severe disease, steroids have been widely employed and have shown to possess an anti-inflammatory activity, but about 20-30% of patients are not responsive and present recurrence. Some novel immunosuppressors have already been employed in clinical studies and have shown interesting results, although the lack of randomized and controlled trials suggests caution for their use in clinical practice. Potential targets for therapy in GO are the thyroid-stimulating hormone and the insulin-like growth factor 1 receptor on the fibroblasts, inflammatory cytokines, B and T cells, and the PIK3/mTORC1 signaling cascades for adipogenesis.
A recent open study has shown that tocilizumab, an anti-sIL-6R antibody, inactivates GO. Consistent reports on the efficacy of rituximab have recently been challenged by randomized controlled trials.As the main goal of treatment is the well-being of the patient, the therapeutic strategy should be addressed to better suit the patient needs, more than improving one or more biological parameters. The increasing availability of new therapies will expand the therapeutic options for GO patients and allow the clinician to really personalize the treatment to better suit the patients’ personal needs.organization: Fondazione IRCCS Cà Granda, Italy
read more full text
Is My Thyroid Condition to Blame for My Hair Loss?Question: Could my thyroid condition be ...
Nicholas Robert Mahoney, MDNicholas Robert Mahoney is an Associate ...
Jonathan J. Dutton, MD, PhD, FACSJonathan Dutton is a Professor Emeritus ...
...Hyperthyroidism is caused when the thyro...
Dr. Alon Kahana – Management of Dry Eyeshttps://www.youtube.com/watch?v=xat5SBU_...
Steven Elliott Feldon, MD, MBASteven Elliott Feldon is an internationa...
Genetic Associations of the Thyroid Stimulating Hormone Receptor Gene With Graves’ Diseases and Graves’ ...Graves' disease (GD) is a common thyroid...
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.