English
SpanishTrusted 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
year: 2016
authors: Campi I, Vannucchi G, Salvi M
summary/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, ItalyDOI: 10.1530/EJE-15-1164
read more full text
myBinderRelated Content
-
Dr. Scott Rivkees – “Treatment/Monitoring of Childhood Graves’ Disease – What a Parent Shoul...https://www.youtube.com/watch?v=-HttLLtR...
-
Clinical Implications of Immunoglobulin G4 to Graves’ OphthalmopathyBackground: This study aimed to explore...
-
Scheie Eye Institute – Thyroid Eye Disease ProgramScheie’s Thyroid Eye Disease Program o...
-
Consensus Statement of the European Group on Graves’ Orbitopathy (EUGOGO) on Management of Graves’ Orbit...Graves’ orbitopathy (GO) constitutes a...
-
Predicting Risk of Recurrent Thyrotoxicosis Following Thionamide Withdrawal in Graves’ DiseaseBackground/Aim: Thionamides are a safe ...
-
A Validated Tool Can Predict Risk of Developing Thyroid Eye Disease During Antithyroid Drug Treatment of Graves’ D...Over-activity of the thyroid gland, call...
-
Michael K. Yoon, MDDr. Michael Yoon is a member of the Mass...
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.
Powered by
Brought to you by
Supported through an independent
educational grant by
