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  • Doxycycline for Mild Thyroid Eye Disease

    By Jean Shaw
    Selected and reviewed by Neil M. Bressler, MD, and Deputy Editors
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    Journal Highlights

    JAMA Ophthalmology, November 2022

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    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.