Puls-therapy with metilprednisolon in Grave's orbitopathy

Abstract

There are different intravenous (iv) glucocorticoid (GC) schedules to treat active Graves’ Orbitopathy (GO). There is one study compared the efficacy of two different pulse-therapy regimens (Sanchez-Ortiga R. et al, 2009): first regimen - traditional therapy, second – GC dose dependents on body weight. Both regimens were effective, but percentage clinical improvement with second regimen was 92% vs 100% with second regimen.Design. The present study compares the efficacy of two different intravenous methylprednisolone (ivGC) dosing regimens: 1000 mg of ivGC daily for 5 days (group I, n = 20) or weekly for 5 weeks (group II, n = 16). Comparisons were made for efficacy according to СAS, exophthalmos, diplopia in 1, 4, 12, 24, 52 weeks after treatment withdrawal. Results. Both regimens had a beneficial effect on soft tissue, exophthalmos. In the first regimen peak of effectiveness occurred between 4 and 24 weeks, in the second regimen- between 4 and 12 weeks. The daily regimen led quickly to reduce the degree of diplopia than weekly dosing regimen. However, in the first group more patients were reported diplopia progression compared with the second group.Conclusion. Both schedules were equally effective and can be used in clinical practice.