Graves Ophthalmopathy

Thyroid Associated Ophthalmopathy

Thyroid Associated Orbitopathy

Simvastatin 40mg

Dpt. of Endocrinology, SUS Malmö

Treatment of Graves´Ophthalmopathy With Simvastatin (GO-DS)

Change in 7-point clinical activity score (CAS) after 6 months treatment with simvastatin or no treatment

Number of patients with progression to severe GO in each group (simvastatin, no treatment) during 6 months treatment

Change in Modified clinical activity score after 3 and 6 months treatment with simvastatin or no treatment

Evaluation of conjunctival thickness with optical coherence tomography after 3 and 6 months treatment with simvastatin or no treatment

Quality of life after 6 months treatment with simvastatin or no treatment assessed with the SF36 questionnaire

Quality of life after 6 months treatment with simvastatin or no treatment assessed with the ThyPro questionnaire

Quality of life after 6 months treatment with simvastatin or no treatment assessed with the GO-QoL questionnaire

TRAb after 3 and 6 months treatment with simvastatin or no treatment

TPOAb after 3 and 6 months treatment with simvastatin or no treatment

Lund University

12 months treatment with diclofenac 50 mg 1x2 in addition to regular treatment for thyrotoxicosis.

12 months treatment without diclofenac in addition to regular treatment for thyrotoxicosis.

Graves´ Disease

T Diclofenac 50 mg twice daily for 12 months

Diclofenac

Methimazole

L-thyroxin approximately 100 to 200 micrograms/day. The dose is adjusted to reach euthyroidism during concomitant treatment with methimazole for 18 months

L-thyroxin

T Propronalol 40mg 1x1-3 during during 1-3 weeks until the patient has responded to thyrostatics

Propranolol

T Metoprolol 50 mg 1x3 for 1-3 weeks until the patient has responded to thyrostatics

Metoprolol

Departmenty of Endocrinology, Skane University Hospital

Department of Endocrinology, Karolinska Hospital

Department of Internal Medicine, section of Endocrinology, Sodersjukhuset

Adjuvant Treatment of Graves´ Ophthalmopathy With NSAID (aGO Study)

Optic nerve dysfunction 0. No 1. Yes Eye-lid edema 0. No 1. Yes Chemosis 0. No 1. Yes Conjunctival injection 0. No 1. Yes Exophthalmos 0. No 1. Yes Hertel - base right left Eye muscle dysfunction 0. No 1. Yes Corneal ulcers 0. No 1. Yes
Sum:
Ophthalmopathy is present if the patient has one sign or more.

Spontaneous retrobulbar pain 0. No 1. Yes Painfull eye-movements 0. No 1. Yes Eye-lid erythema 0. No 1. Yes Conjunctival injection 0. No 1. Yes Chemosis 0. No 1. Yes Swollen caruncula 0. No 1. Yes Eye-lid edema or swolleness 0. No 1. Yes
Sum:

Criteria for start of steroid treatment are: 1. Risk of corneal ulcers with or without exophthalmos 2. Double vision within 30 degrees 3. Optic nerve dysfunction.

Mikael Lantz

Associate Professor

Thyroid Associated Ophthalmopathies

Graves´ Ophthalmopathy

Thyroid Eye Disease

Single intravenous infusion of tocilizumab (8 mg/kg); every 4 weeks during 16 weeks.

Tocilizumab (RoActemra®)

Single intravenous dip infusion of a sterile 0.9% sodium chloride, every four weeks during 16 weeks.

Sterile 0.9% Sodium Chloride

Hospital Clínico de Santiago

Hospital Santa Creu i Sant Pau

Hospital Clínico San Carlos

Hospital Universitario Ramón y Cajal

Centro Oftalmológico Moreiras

Hospital Universitario Virgen del Rocío

Hospital Universitario Virgen Macarena

Hospital Universitario La Fe

Hospital Clínico Universitario Lozano Blesa

Tocilizumab Treatment in Graves´ Ophthalmopathy (Graves´ Orbitopathy or Thyroid Eye Disease)

Clinical Trial Phase III, Parallel Group, Randomized, Placebo-controlled, Double-blind, Multicenter Study to Evaluate the Efficacy and Safety of Tocilizumab Administration in Patients With Moderate-to-severe or Sight-threatening Graves' Ophthalmopathy (GO), That Had Not Responded Adequately to Treatment With Intravenous Corticoid Pulses.

exophthalmos/obrzęk

Treatment of Graves´Ophthalmopathy With Simvastatin (GO-DS)

Adjuvant Treatment of Graves´ Ophthalmopathy With NSAID (aGO Study)

Tocilizumab Treatment in Graves´ Ophthalmopathy (Graves´ Orbitopathy or Thyroid Eye Disease)

The Role of TSH Receptor, PPAR-r, IGF-1R, IGF and Cytokines in Different Stages of Graves'Ophthalmopathy

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