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Therapeutic efficacy predictors of methylprednisolone in thyroid-associated ophthalmopathy

10 Oct 2018

The efficacy of intravenous methylprednisolone (IVMP) for treating moderate-to-severe active thyroid-associated ophthalmopathy (TAO) may be predicted by factors such as levels of thyroid stimulating hormone (TSH), anti-TSH-receptor antibodies (TRABs) and triglycerides, as well as eye symptom duration, a study reports.

Researchers looked at 302 consecutive patients with moderate-to-severe and active TAO who underwent the full IVMP therapy course. They identified independent predictors of treatment efficacy in the training set (n=200) and validated the prediction model in the validation set (n=102).

Multivariable logistic regression analysis revealed therapeutic efficacy to be associated with pretreatment clinical activity score (odds ratio [OR], 3.506; p<0.001), elevated TSH levels during treatment (OR, 0.145; p=0.005), pretreatment anti-TRAB levels (OR, 0.061; p<0.001), duration of eye symptoms (OR, 0.878; p=0.017) and pretreatment triglyceride levels (OR, 0.090; p=0.001).

The multivariable prediction model demonstrated good calibration and excellent discrimination, with an area under curve of 0.915 in the training set (p<0.001) and 0.885 (p<0.001) in the validation set.

Overall, the present data indicate that low pretreatment clinical activity score, positive pretreatment TRAB levels, prolonged duration of eye symptoms, elevated TSH levels during treatment, and high pretreatment triglyceride levels may negatively affect IVMP efficacy for moderate-to-severe TAO, according to researchers.

Additionally, the prediction model may help clinicians determine the indication and prognosis of IVMP therapy. In the management of TAO patients, researchers suggested early diagnosis and treatment (within 15 months), prompt restoration and maintenance of euthyroidism (meticulous control of TSH levels, ≤5 μIU/mL) and regular monitoring of triglyceride levels.

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Most Read Articles
Stephen Padilla, 14 Aug 2019
Early administration of recombinant human B-type natriuretic peptide (rhBNP) can lower the incidence of reperfusion injury for patients with ST-elevation myocardial infarction (STEMI) who are receiving percutaneous coronary intervention (PCI) treatment, according to a China study.
11 Aug 2019
Intraoperative methylprednisolone does not appear to significantly prevent the incidence of death, cardiac arrest and other injuries in neonates undergoing cardiac surgery with cardiopulmonary bypass, according to a recent study.
3 days ago
Pulmonary function has potential predictive value for future increases in arterial stiffness and its progression, as reported in a recent study.
2 days ago
Systolic blood pressure appears to have a strong association with aneurysmal subarachnoid haemorrhage (aSAH) but not with unruptured intracranial aneurysm (UIA), whereas current smoking and female sex are risk factors for both conditions, a study has found.