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

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Abstract


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

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