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Outcome of Graves' orbitopathy after total thyroid ablation and glucocorticoid treatment: follow-up of a randomized clinical trial.

Authors :
Leo M
Marcocci C
Pinchera A
Nardi M
Megna L
Rocchi R
Latrofa F
Altea MA
Mazzi B
Sisti E
Profilo MA
MarinĂ² M
Source :
The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2012 Jan; Vol. 97 (1), pp. E44-8. Date of Electronic Publication: 2011 Oct 26.
Publication Year :
2012

Abstract

Context: In a previous study, we found that total thyroid ablation (thyroidectomy plus (131)I) is associated with a better outcome of Graves' orbitopathy (GO) compared with thyroidectomy alone, as observed shortly (9 months) after glucocorticoid (GC) treatment.<br />Objective: The objective of the study was to evaluate the outcome of GO in the same patients of the previous study over a longer period of time.<br />Design: This was a follow-up of a randomized study.<br />Setting: The study was conducted at a referral center.<br />Patients: Fifty-two of 60 original patients with mild to moderate GO participated in the study.<br />Interventions: Patients randomized into thyroidectomy (TX) or total thyroid ablation and treated with GC were reevaluated in 2010, namely 88.0 ± 17.7 months after GC, having undergone an ophthalmological follow-up in the intermediate period.<br />Main Outcome Measures: The main outcome measures included the following: 1) GO outcome; 2) time to GO best possible outcome and to GO improvement; and 3) additional treatments.<br />Results: GO outcome at the end of the follow-up was similar in the two groups. However, the time required for the best possible outcome to be achieved was longer in the TX group (24 vs. 3 months, P = 0.0436), as was the time required for GO to improve (60 vs. 3 months, P = 0.0344). Additional treatments were given to a similar proportion of patients in each group (TX, 28%, total thyroid ablation, 25.9%), but they affected GO beneficially more often in the TX group (28 vs. 3.7%, P: 0.0412).<br />Conclusions: Compared with thyroidectomy alone, total thyroid ablation allows the achievement of the best possible outcome and an improvement of GO within a shorter period of time.

Details

Language :
English
ISSN :
1945-7197
Volume :
97
Issue :
1
Database :
MEDLINE
Journal :
The Journal of clinical endocrinology and metabolism
Publication Type :
Academic Journal
Accession number :
22031515
Full Text :
https://doi.org/10.1210/jc.2011-2077