Abstract |
The aim of the work was to investigate the effect of early thyroidectomy on the course of active Graves' orbitopathy (GO) in patients with low probability of remission [high TSH receptor antibody (TRAb) serum levels, severe GO] compared to that of continued therapy with antithyroid drugs. Two cohorts were evaluated retrospectively (total n=92 patients with active GO, CAS≥4). Forty-six patients underwent early thyroidectomy (Tx-group) 6±2 months after initiation of antithyroid drug (ATD) therapy, while ATD was continued for another 6±2 months in the ATD-group (n=46). These controls were consecutively chosen from a database and matched to the Tx-group. GO was evaluated (activity, severity, TRAb) at baseline and at 6 month follow-up. At baseline, both cohorts were virtually identical as to disease severity, activity and duration, as well as prior anti-inflammatory treatment, age, gender, and smoking behavior. At 6 month follow-up, NOSPECS severity score was significantly decreased within each group, but did not differ between both groups. However, significantly more patients of the Tx-group presented with inactive GO (89.1 vs. 67.4%, * p=0.02), and mean CAS score was significantly lower in Tx-group (2.1) than in ADT-group (2.8; * p=0.02) at the end of follow-up. TRAb levels declined in both groups (Tx-group: from 18.6 to 5.2 vs. ATD-group: 12.8-3.2 IU/l, p0=0.07, p6months=0.32). Residual GO activity was lower in Tx-group, associated with a higher rate of inactivation of GO. This allows an earlier initiation of ophthalmosurgical rehabilitation in patients with severe GO, which may positively influence quality of life of the patients.
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Authors | M Meyer Zu Horste, K Pateronis, M K Walz, P Alesina, K Mann, M Schott, J Esser, A K Eckstein |
Journal | Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme
(Horm Metab Res)
Vol. 48
Issue 7
Pg. 433-9
(Jul 2016)
ISSN: 1439-4286 [Electronic] Germany |
PMID | 27351809
(Publication Type: Journal Article)
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Copyright | © Georg Thieme Verlag KG Stuttgart · New York. |
Chemical References |
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Topics |
- Anti-Inflammatory Agents
(therapeutic use)
- Disease Progression
- Female
- Follow-Up Studies
- Graves Ophthalmopathy
(drug therapy, pathology, surgery)
- Humans
- Male
- Middle Aged
- Retrospective Studies
- Thyroidectomy
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