Radioiodine-Associated Exacerbation of Graves' Orbitopathy in the Japanese Population: Randomized Prospective Study
| Autor: | Ai Yoshihara, Masako Matsumoto, Yuka Kosuga, Natsuko Watanabe, Hidemi Ohye, Miho Suzuki, Yo Kunii, Jaeduk Yoshimura Noh, Kenji Iwaku, Koji Mukasa, Kiminori Sugino, Sakiko Kobayashi, Tosyu Inoue, Kenichi Sekiya, Ai Kozaki, Koichi Ito |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Exacerbation Prednisolone Endocrinology Diabetes and Metabolism Graves' disease Clinical Biochemistry Context (language use) Chemoprevention Biochemistry Iodine Radioisotopes Graves' ophthalmopathy Young Adult Endocrinology Japan hemic and lymphatic diseases Internal medicine medicine Humans Young adult Radiation Injuries Prospective cohort study Aged business.industry Biochemistry (medical) Middle Aged medicine.disease Graves Disease Graves Ophthalmopathy Go/no go Disease Progression Female business medicine.drug |
| Zdroj: | The Journal of Clinical Endocrinology & Metabolism. 100:2700-2708 |
| ISSN: | 1945-7197 0021-972X |
| Popis: | Exacerbation of Graves' orbitopathy (GO) after radioiodine (RAI) therapy has been examined in some populations but has not been fully described in Japanese populations.The purpose of this study was to clarify the characteristics of GO exacerbation after RAI therapy and the effectiveness of low-dose prophylactic corticosteroid (PCS).This was a prospective randomized study in Tokyo, Japan.Between June 2011 and June 2012, 295 patients with Graves' disease with either inactive GO or no GO received RAI therapy. Of these, 147 received no PCS (PCS-Off group), whereas 148 received low-dose PCS (starting dose, 15 mg/day of prednisolone) for 6 weeks (PCS-On group). We used magnetic resonance imaging to thoroughly evaluate GO before and 1 year after RAI therapy.Outcomes of GO 1 year after RAI therapy were determined.GO exacerbation occurred in 29 patients (9.8%), and only 7 patients (2.4%) required ophthalmic treatment. No significant difference in the frequency of GO exacerbation was seen between the groups (PCS-On group: n = 18 [12.1%]; PCS-Off group: n = 11 [7.5%]; P = .17). Significant prognostic factors were identified as thyroid-stimulating antibody (by 100% linear increase: risk ratio, 1.15; 95% confidence interval, 1.07-1.24; P = .0003) and clinical activity score (≥1 vs 0: risk ratio, 6.40; 95% confidence interval, 2.17-19.7; P = .0009).Exacerbation of GO after RAI therapy in the Japanese population appears less common than in other populations. Low-dose PCS did not produce a significant preventive effect and appeared insufficient. Patients presenting with risk factors would thus be recommended to receive higher-dose PCS. |
| Databáze: | OpenAIRE |
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