Predictive factors for treatment response in active thyroid eye disease.

Area of Science:

• Endocrinology
• Ophthalmology

Background:

• Active moderate-to-severe thyroid eye disease (TED) presents a significant therapeutic challenge.
• Intravenous glucocorticoid pulse therapy is standard but yields variable responses.
• Radioactive iodine therapy (RAI) has been implicated as a risk factor for TED onset or worsening.

Purpose of the Study:

• To identify predictive factors for successful response to intravenous methylprednisolone pulse therapy in active TED patients.
• To evaluate the safety and efficacy of concurrent Radioactive Iodine Therapy (RAI) with pulse therapy.

Main Methods:

• Retrospective analysis of 64 patients with active moderate-to-severe TED treated with intravenous methylprednisolone.
• Patients classified as responders or non-responders based on Clinical Activity Score (CAS).
• Comparison of clinical features and outcomes, including timing of RAI treatment.

Main Results:

• Pulse therapy was effective in the majority of patients (73.4% responders).
• No significant differences in response based on gender, age, thyroid function, antibodies, disease duration, or smoking status.
• Response rate was higher when RAI was administered during pulse therapy compared to after, and similar to no RAI treatment.

Conclusions:

• Intravenous methylprednisolone pulse therapy is effective for most patients with active TED.
• The timing of RAI administration is a key factor influencing treatment response.
• Concurrent RAI administration during pulse therapy appears safe and potentially beneficial.