Doxycycline for Mild Thyroid Eye Disease
By Jean Shaw
Selected and reviewed by Neil M. Bressler, MD, and Deputy Editors
Journal Highlights
JAMA Ophthalmology, November 2022
Download PDF
Pan et al. evaluated the efficacy of doxycycline in treating mild thyroid-associated ophthalmopathy (TAO). They found that 50 mg of oral doxycycline, given daily, resulted in greater improvement of mild TAO-related symptoms at 12 weeks compared with placebo.
For this placebo-controlled double-masked trial, 100 patients at five centers in China were randomly assigned 1:1 to receive doxycycline or placebo once a day for 12 weeks. The primary outcome was the rate of improvement at the 12-week mark compared with baseline, assessed by a composite indicator of eyelid aperture (reduction ≥2 mm), proptosis (reduction ≥2 mm), ocular motility (increase of ≥8 degrees), and improvement on the Graves ophthalmopathy–specific quality-of-life scale (≥6 points). Adverse events were recorded, and medication compliance was checked during participant interviews and by counting excess tablets.
At week 12, 19 (38%) of those in the doxycycline group had improved, versus eight (16%) of those who received placebo. With regard to adverse events, one person in the doxycycline group experienced mild acid reflux and was switched to omeprazole.
The researchers noted that the relatively short-term duration of follow-up and small sample size warrants longer-term studies with larger cohorts. (Also see related commentary by Jiawei Zhao, MD, and Bita Esmaeli, MD, in the same issue.)
The original article can be found here.