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  • Intravenous glucocorticoids superior to oral glucocorticoids in Graves' orbitopathy

    Oculoplastics/Orbit

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    This meta-analysis confirmed that intravenous glucocorticoids (IVGC) are significantly more effective and better-tolerated than oral glucocorticoids (OGC) in the treatment of moderate-to-severe Graves' ophthalmopathy.

    The authors investigated whether intravenous glucocorticoids offer any advantages over oral glucocorticoids, orbital radiotherapy, orbital decompression or placebo in the treatment of active and moderate-to-severe Graves' ophthalmopathy. Eight studies involving 376 patients were included.

    They found that IVGC was significantly more effective than OGC (risk ratio = 1.48). Combining IVGC and orbital radiotherapy (OR) was markedly more effective than OGC+OR (RR = 1.40). Additionally, IVGC resulted in an obvious reduction of clinical activity score.

    The authors advise limiting the total cumulative dose of methylprednisolone, careful patient selection and close patient monitoring during treatment.