New immunomodulators in the treatment of Graves' ophthalmopathy

Annales d'endocrinologie
Mario SalviPaolo Beck-Peccoz

Abstract

Steroids have been used in the therapy of the moderate to severe forms of Graves' ophthalmopathy (GO) and other autoimmune diseases as they act only as general immunosuppressants. Previous work has shown that blocking the CD-20 receptor on B lymphocytes has significantly affected the clinical course of GO, by rapidly reducing inflammation and the degree of proptosis. We have studied nine patients with Graves' disease, of whom seven had active GO and two, with newly diagnosed hyperthyroidism, only mild lid signs. We also studied a group of 20 consecutive patients, treated with intravenous glucocorticoids (IVGC) according to a standard protocol. Patients treated with RTX (1000mg i.v. twice at two-week interval) and those treated with IVGC (500mg i.v. for 16 weeks) were studied monthly up to 12 months after the first drug infusion. By ophthalmological examination, GO was assessed by the clinical activity score (CAS) and by the NOSPECS score. Thyroid function and lymphocyte count were measured by standardized methods. RTX was well-tolerated and only minor side-effects were reported in 30% of patients during the first infusion. All patients attained peripheral B-cell depletion with the first RTX infusion. All but one patients showed...Continue Reading

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Citations

Nov 3, 2010·Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus·Linda R DagiOscar A Cruz
Jul 29, 2011·Reumatología clinica·Carmen María Escudero GonzálezJosé Luis Marenco de la Fuente
Jun 22, 2010·Ophthalmic Plastic and Reconstructive Surgery·Rona Z SilkissSimeon A Lauer
Aug 20, 2017·International Ophthalmology·Rashmi Kumari, Bhawesh Chandra Saha

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