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Safety of different types of methylprednisolone puls-therapy in the treatment of Graves' orbitopathy

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According to the EUGOGO’s (European Group On Graves' Orbitopathy) last consensus, the treatment of choice for Graves’ Orbitopathy (GO) is pulses of glucocorticoid (GC). There is a lack of evidence for superiority of any intravenous (iv) GC schedules. As a rule this therapy is pretty safe. However, acute cardiovascular diseases and acute severe liver damage has been reported in sporadic cases during ivGC, resulting in fatal acute liver failure in a few patients. Design: we performed a prospective study in 36 Graves' patients with GO who were treated with 1000 mg of ivGC daily for 5 days (group I, n = 20) or weekly for 5 weeks (group II, n = 16). Results: ALAT and ASAT increases were much more prominent in group I than in group II especially during the treatment and in the first 4 weeks after the treatment. Increase of blood pressure, glycemia and negative ECG alterations in group I resulted to their management. And we revealed much more patients complains in group I. Conclusion: Both schedules seem to be pretty safe, but therapy once a week (for 5 weeks) is safer and allows to treat patients in outpatient clinics, reduce expenditures on inpatient care, accelerate of initial treatment and include more patients into treatment.

Email: studyx@mail.ru
aspirantka kafedry endokrinologii Pervogo MGMU im. I.M. Sechenova

doktor med. nauk, zaveduyushchiy otdeleniem oftal'mologii FGU Endokrinologicheskiy nauchnyy tsentr Minzdravsotsrazvitiya RF

doktor med. nauk, zamestitel' direktora FGU Endokrinologi- cheskiy nauchnyy tsentr Minzdravsotsrazvitiya RF, professor kafedry endokrinologii Pervogo MGMU im. I.M. Sechenova

  1. Современные аспекты глюкокортикоидной терапии ревматических заболеваний. Под ред. В.А. Насоновой. Пособие для врачей, 2009.
  2. Bartalena L., Baldeschi L., Dickinson A.J. et al. Consensus Statement of the European Group on Graves' Orbitopathy (EUGOGO) on Management of Graves' Orbitopathy. Thyroid. 2008; 18: 3: 333–346.
  3. Dourakis S.P., Sevastianos V.A., Kaliopi P. Acute severe steatohepatitis related to prednisolone therapy.Am J Gastroenterol. 2002; 97 (4): 1074–1075.
  4. Hiromatsu Y. Steroid therapy for Graves' ophthalmopathy Nippon Rinsho. 2006; 64 (12): 2279–2285.
  5. Kahaly G.J., Zang S., Ponto K.A. Intravenous glucocorticoids for graves' orbitopathy: efficacy and morbidity. J. Clin. Endocrinol. Metab. 2011; 96 (2): 320–332. Epub 2011 Jan 14.
  6. Le Moli R., Baldeschi L., Saeed P. et al. Determinants of liver damage associated with intravenous methylprednisolone pulse therapy in Graves' ophthalmopathy. Thyroid. 2007; 17 (4): 357–362.
  7. Marino M., Morabito E., Brunetto M.R. et al. Acute and severe liver damage associated with intravenous glucocorticoid pulse therapy in patients with Graves' ophthalmopathy. Thyroid. 2004; 14 (5): 403–406.
  8. Marcocci C., Watt T. et al. Fatal and non-fatal adverse events of glucocorticoid therapy for Graves’ orbitopathy: a questionnaire survey among members of the European Thyroid Association. Eur. J. Endocrinol. 2012; 166: 247–253.


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