Abstract
Background: Clucocorticoids are treatment od choice for moderate to severe Graves\ ophthalmopathy (GO).
Objective: The aim of this study was to evaluate effects of gender, age, smoking, duration of eye disease, duration of hyperthyroidism, Cnical activity score (CAS) and TSH receptor antibody (TSH r At) levels on the response to glucocorticoids in patients with GO.
Methods: Study group consisted of 42 patients with severe GO treated with 2 doses of 500mg of methylprednisolon during 3 days followed by oral prednisone 40mg/d tapered to 10mg/d in 4 weeks. The treatment lasted for 6 months.
Results: After 6 months, 29 of 42 patients (69,1%) had a treatment response. Eleven of 13 nonsmokers (85%) and 18 of 29 smokers (62%) responded to treatment. Patients with CAS 4 responded better (77%) compared with patients with CAS<4 who had treatment response of 50%. Favorable response was in group with shorter interval between the onset of eye disease and the start of treatment (14±14 months vs. 16±13) as well as in group with higher TSHrAt levels (16±16 vs. 6±2). The responders were not different from non-responders with regard to age, gender and duration of hyperthyroidism.
Conclusion: The response to glucocorticoid therapy dependent on smoking behavior, CAS, duration of eye disease and TSHrAb levels.