Randomized double-blind trial of prednisone versus radiotherapy in Graves' ophthalmopathy

Journal Article · Sat Oct 16 00:00:00 EDT 1993 · Lancet; (United States)

DOI:https://doi.org/10.1016/0140-6736(93)92001-A· OSTI ID:5774219

Prummel, M F; Mourits, M; Blank, L; Berghout, A; Koornneef, L; Wiersinga, W M ^[1]

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1. Univ. of Amsterdam (Netherlands)

Corticosteriods are usually given for management of Graves' ophthalmopathy, but they have many and serious side-effects. By comparison, retrobulbar irradiation is well tolerated, although its efficacy has been evaluated only in uncontrolled studies. Therefore, the authors did a double-blind randomized trial, in which 28 patients with moderately severe Graves' ophthalmopathy were treated with a 3-month course of oral prednisone and sham irradiation, and 28 received retrobulbar irradiation (20 Gy) and placebo capsules. Therapeutic outcome, assessed twenty-four weeks after the start of treatment, was determined by the change in the highest NOSPECS class. A successful outcome was observed in 14 prednisone-treated and in 13 irradiated patients. Responders to treatment (but not nonresponders) in both groups showed improvements in total and subjective eye score and a decrease in eye-muscle volume. Response to either treatment was due largely to changes in soft-tissue involvement and eye-muscle motility. Radiotherapy and oral prednisone appear to be equally effective as initial treatment in patients with moderately severe Graves' ophthalmopathy. In view of its better tolerability, radiotherapy should be considered the treatment of first choice.

• OSTI ID: 5774219
• Journal Information: Lancet; (United States), Vol. 342:8877; ISSN 0099-5355
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
PREDNISONE
THERAPEUTIC USES
SENSE ORGANS DISEASES
RADIOTHERAPY
COMPARATIVE EVALUATIONS
EYES
OPHTHALMOLOGY
ADRENAL HORMONES
BODY
BODY AREAS
CORTICOSTEROIDS
DISEASES
EVALUATION
FACE
GLUCOCORTICOIDS
HEAD
HORMONES
HYDROXY COMPOUNDS
KETONES
MEDICINE
NUCLEAR MEDICINE
ORGANIC COMPOUNDS
ORGANS
PREGNANES
RADIOLOGY
SENSE ORGANS
STEROID HORMONES
STEROIDS
THERAPY
USES
550603* - Medicine- External Radiation in Therapy- (1980-)