In this study, nine patients with
Graves' ophthalmopathy with positive clinical activity score (CAS), who were either unresponsive or not suitable for
glucocorticoid treatment, were given 100 microg of
octreotide three times daily, subcutaneously, for three months. The mean age was 49+/-13 years. All patients were under either
propylthiouracil or
methimazole therapy and were euthyroid for at least one month prior to the start of the
octreotide treatment. The mean degree of
proptosis as measured with the Hertel exophthalmometer decreased slightly after the treatment (22.0+/-3.0 vs 19.6+/-2.4 for the right eye and 22.2+/-1.9 vs 20.2+/-2.2 for the left eye; p<0.05). The mean activity score decreased from 3.2+/-0.8 to 1.7+/-1.1 (p<0.005) and the mean score of eye signs according to the NOSPECS classification showed improvement with
octreotide therapy (3.2+/-0.7 vs. 2.2+/-1.4; p<0.05). Seven patients responded favorably to
octreotide treatment. In the remaining two no improvement was observed. Four of the responders could be followed up for 20 months after the treatment and all maintained the favorable state of eye findings obtained with
octreotide. We conclude that
octreotide seems to be a safe and effective
drug in
Graves' ophthalmopathy, especially in improving soft tissue involvement, and can be used in patients who are unresponsive to
glucocorticoid treatment or who cannot use these drugs for some reason.