Steroid treatment focused management of Graves’ ophthalmopathy
DOI:
https://doi.org/10.2478/66Keywords:
Graves’ disease, Graves’ ophthalmopathy, Graves’ orbitopathy, glucocorticoidsAbstract
Introduction: Graves’ disease (GD) is an autoimmune disease that affects the thyroid and the eyes. Graves’ ophthalmopathy (GO), an autoimmune disease, usually appears 18 months after GD diagnosis. Clinical activity and disease severity determine the
strategy, with steroid treatment recommended during active disease progression. Aim: This review aims to provide an overview of steroid therapy in the treatment of Graves’ ophthalmopathy, discussing its efficacy, protocols, and considerations. Materials and Methods: We reviewed the papers focusing on management recommendations and assessed peer-reviewed publications using the following keywords: “Graves’ disease”, “Graves’ ophthalmopathy”, “Graves’ orbitopathy”, “glucocorticoids”. Results and Discussion: Steroid therapy, especially glucocorticoids, is a primary pharmacologic intervention for clinically active GO. Intravenous administration has shown superior outcomes compared to oral administration, with a recommended protocol that uses a cumulative dose of 4.5 grams methylprednisolone. High-dose systemic glucocorticoids possess anti-inflammatory and immunosuppressive characteristics and are efficacious in managing moderate to severe active GO. Second-line therapies, such as methylprednisolone monotherapy or in combination with cyclosporine, may be considered. Conclusion: Graves’ ophthalmopathy requires intravenous glucocorticoids during the active phase. Intravenous glucocorticoids are more effective and better tolerated than oral glucocorticoids. Patients with Graves’
ophthalmopathy require individualized treatment plans that address contraindications and side effects to improve outcomes and quality of life.
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