NOV 25, 2014
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.