Intravenous Methylprednisolone Pulse Therapy in the Treatment of Graves' Ophthalmopathy
| Autor: | Jean-Michel Petit, S Rudoni, A. Brun-Pacaud, George E. Vaillant, G Matejka, J M Brun, Bruno Vergès |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Adult
Male medicine.medical_specialty Visual acuity Endocrinology Diabetes and Metabolism Graves' disease Clinical Biochemistry Pulse therapy Methylprednisolone Biochemistry Graves' ophthalmopathy Endocrinology Prednisone Internal medicine Outpatients medicine Humans Adverse effect Tomography Aged Pulse (signal processing) business.industry Smoking Biochemistry (medical) General Medicine Middle Aged medicine.disease Graves Disease Ophthalmology Treatment Outcome Anesthesia Injections Intravenous Female medicine.symptom business Immunosuppressive Agents medicine.drug |
| Zdroj: | Hormone and Metabolic Research. 30:93-98 |
| ISSN: | 1439-4286 0018-5043 |
| DOI: | 10.1055/s-2007-978843 |
| Popis: | Graves' ophthalmopathy (GO) is a specific immune-mediated disorder, whose treatment is sometimes difficult. In order to investigate the efficacy of intravenous methylprednisolone (MP) pulse therapy in GO, we studied eight patients with GO, followed up for at least 6 months by clinical patient self-assessment, ophthalmological examination and orbital computed tomography (OCT). A 12.5 mg/kg dose of MP was administered intravenously over a 10 hour period, once every month. Three to six MP pulse administrations were performed in each patient. All patients were outpatients. A 0.5 mg/kg/day oral prednisone dose was given to each patient as interpulse therapy. Clinical assessment of MP pulse therapy showed a good response in 87.5% and no response in 12.5% of patients. The treatment was rapidly efficient, mostly on patient self-assessment, soft tissue inflammation, ophthalmoplegia, corneal involvement, visual acuity and extraocular muscle enlargement on OCT. Post-treatment ophthalmic index was significantly improved (6.75 +/- 3.06 vs. 2.5 +/- 1.41: p < 0.05). MP pulse therapy had less effect on proptosis (22.94 +/- 2.32 mm vs. 21.56 +/- 2.22 mm: p < 0.05). No adverse effects were noted with MP pulse therapy. Patients showed no relapse of eye involvement during a mean follow up of 31.8 months (2-77 months). In conclusion, our results suggest that intravenous MP pulse therapy is a good immunosuppressive therapy for GO. Moreover, in comparison with the previous studies, the MP dose used in our present study appears to be optimal with high efficacy. MP pulse therapy represents a safe and efficient treatment in GO, which can easily be performed in outpatients. |
| Databáze: | OpenAIRE |
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