Methylprednisolone pulse therapy for patients with moderately severe Graves' orbitopathy: a prospective, randomized, placebo-controlled study Export

@article{citeulike:2308050, abstract = {ObjectiveTo assess whether methylprednisolone (MP) pulse therapy is efficacious in the treatment of moderately severe Graves' orbitopathy (GO). DesignProspective, placebo (PL)-controlled, double-blind, randomized study. MethodsFifteen previously untreated patients with active, moderately severe GO participated in the study; 6 patients received MP and 9 patients a PL. Moderately severe disease was defined using the NOSPECS classification of clinical signs of GO . Activity was measured with the clinical activity score (CAS). A dose of 500 mg MP or only solvent was administered intravenously, over three consecutive days, in four cycles at 4 weekly intervals (6 g of MP in total). Qualitatively, a successful treatment outcome was defined as an improvement in one major and/or two minor criteria in the worst eye at week 48. The major criteria were: improvement in diplopia grade; improvement in eye movement; a decrease in CAS of three points. The minor criteria were: decrease of eyelid retraction; decrease of proptosis; improvement in grade of soft tissue swelling; a decrease in CAS of two points. ResultsThe qualitative treatment outcome was successful at the end of the trial in five out of six (83\%) patients receiving MP and in one out of nine (11\%) patients given the PL (relative risk=7.5; (95\% confidence interval 1.149.3), P=0.005). The treatment was well tolerated. ConclusionsIn spite of the small number of patients, a significant difference in outcome was observed between MP- and PL-treated patients. We conclude that MP pulse therapy appears to be an effective treatment for active, moderately severe GO. 10.1530/EJE-07-0558}, author = {van Geest, Rob J. and Sasim, Inna V. and Koppeschaar, Hans P. and Kalmann, Rachel and Stravers, Simone N. and Bijlsma, Ward R. and Mourits, Maarten P.}, citeulike-article-id = {2308050}, citeulike-linkout-0 = {http://dx.doi.org/10.1530/EJE-07-0558}, citeulike-linkout-1 = {http://www.eje-online.org/cgi/content/abstract/158/2/229}, citeulike-linkout-2 = {http://view.ncbi.nlm.nih.gov/pubmed/18230831}, citeulike-linkout-3 = {http://www.hubmed.org/display.cgi?uids=18230831}, comment = {Un RCT que muestra una buena efectividad de tto. sin mayores efectos colaterales. Para Exoftalmopat\'{\i}as moderadas a severas. No preciso si es generalizable a exoftalmopat\'{\i}as minimas.}, day = {1}, doi = {10.1530/EJE-07-0558}, journal = {Eur J Endocrinol}, keywords = {graves, hyperthyroidism, rct, therapy}, month = {February}, number = {2}, pages = {229--237}, posted-at = {2008-01-30 17:32:28}, priority = {2}, title = {Methylprednisolone pulse therapy for patients with moderately severe Graves' orbitopathy: a prospective, randomized, placebo-controlled study}, url = {http://dx.doi.org/10.1530/EJE-07-0558}, volume = {158}, year = {2008} }

TY - JOUR ID - citeulike:2308050 L3 - citeulike-article-id:2308050 N2 - ObjectiveTo assess whether methylprednisolone (MP) pulse therapy is efficacious in the treatment of moderately severe Graves' orbitopathy (GO). DesignProspective, placebo (PL)-controlled, double-blind, randomized study. MethodsFifteen previously untreated patients with active, moderately severe GO participated in the study; 6 patients received MP and 9 patients a PL. Moderately severe disease was defined using the NOSPECS classification of clinical signs of GO . Activity was measured with the clinical activity score (CAS). A dose of 500 mg MP or only solvent was administered intravenously, over three consecutive days, in four cycles at 4 weekly intervals (6 g of MP in total). Qualitatively, a successful treatment outcome was defined as an improvement in one major and/or two minor criteria in the worst eye at week 48. The major criteria were: improvement in diplopia grade; improvement in eye movement; a decrease in CAS of three points. The minor criteria were: decrease of eyelid retraction; decrease of proptosis; improvement in grade of soft tissue swelling; a decrease in CAS of two points. ResultsThe qualitative treatment outcome was successful at the end of the trial in five out of six (83%) patients receiving MP and in one out of nine (11%) patients given the PL (relative risk=7.5; (95% confidence interval 1.149.3), P=0.005). The treatment was well tolerated. ConclusionsIn spite of the small number of patients, a significant difference in outcome was observed between MP- and PL-treated patients. We conclude that MP pulse therapy appears to be an effective treatment for active, moderately severe GO. 10.1530/EJE-07-0558 IS - 2 JF - Eur J Endocrinol EP - 237 TI - Methylprednisolone pulse therapy for patients with moderately severe Graves' orbitopathy: a prospective, randomized, placebo-controlled study VL - 158 SP - 229 KW - graves KW - hyperthyroidism KW - rct KW - therapy N1 - Un RCT que muestra una buena efectividad de tto. sin mayores efectos colaterales. Para Exoftalmopatías moderadas a severas. No preciso si es generalizable a exoftalmopatías minimas. AU - van Geest, Rob AU - Sasim, Inna AU - Koppeschaar, Hans AU - Kalmann, Rachel AU - Stravers, Simone AU - Bijlsma, Ward AU - Mourits, Maarten PY - 2008/02/01/ UR - http://dx.doi.org/10.1530/EJE-07-0558 ER -