Overall safety and efficacy of high-dose and low-dose intravenous glucocorticoid therapy in patients with moderate-to-severe active Graves’ ophthalmopathy
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- Ueda-Sakane Yoriko
- Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
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- Kanamoto Naotetsu
- Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan Department of Endocrinology, Osaka City General Hospital, Osaka 534-0021, Japan
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- Fushimi Yasutaka
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
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- Tanaka-Mizuno Sachiko
- Institute for Advancement of Clinical and Translational Science (iACT), Kyoto University Hospital, Kyoto 606-8507, Japan Department of Biostatistics, Shiga University of Medical Science, Otsu 520-2192, Japan
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- Yasuno Shinji
- Institute for Advancement of Clinical and Translational Science (iACT), Kyoto University Hospital, Kyoto 606-8507, Japan
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- Miura Masako
- Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan Department of Endocrinology, Rakuwakai Otowa Hospital, Kyoto 607-8062, Japan
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- Sone Masakatsu
- Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
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- Yasoda Akihiro
- Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
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- Okada Tomohisa
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
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- Togashi Kaori
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
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- Nakao Kazuwa
- Medical Innovation Center, Kyoto University Graduate School of Medicine, Kyoto 606-8501, Japan
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- Inagaki Nobuya
- Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
書誌事項
- タイトル別名
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- Overall safety and efficacy of high-dose and low-dose intravenous glucocorticoid therapy in patients with moderate-to-severe active Graves’ ophthalmopathy
抄録
The objective of this study was to compare the safety and efficacy of high-dose and low-dose intravenous (iv) glucocorticoid (GC) therapy in patients with Graves’ ophthalmopathy (GO) and to investigate which factors may help determine appropriate iv GC doses. The medical records of 43 patients who received different doses of iv GCs for GO were retrospectively reviewed. Twenty patients received high-dose iv GCs (HD group, cumulative dose 9.0-12.0 g) and 18 received low-dose iv GCs (LD group, cumulative dose 4.5 g). Five patients with previous treatment for GO were excluded. Changes in ophthalmic parameters after treatment and frequencies of adverse effects due to GCs of the 2 groups were compared. We also reviewed the incidence of GO progression and hepatic dysfunction after patients were discharged. We evaluated correlations among pretreatment (before treatment) ophthalmic parameters and investigated useful predictive factors for determining iv GC doses. There were no significant differences in ophthalmic parameters reflecting treatment efficacy or overall safety between the groups. Among baseline ophthalmic parameters, corrected signal intensity ratio (cSIR) correlated well with magnetic resonance imaging findings and were more strongly associated with changes in ophthalmic parameters after treatment in the HD group than in the LD group, indicating that pretreatment cSIR might be useful for determining iv GC doses. In conclusion, there were no significant differences in overall safety and efficacy between high-dose and low-dose iv GC therapy in patients with active GO. Further randomized clinical trials with longer observation periods are required to establish the optimal treatment regimen of GO.
収録刊行物
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- Endocrine Journal
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Endocrine Journal 63 (8), 703-714, 2016
一般社団法人 日本内分泌学会
