Corticosteroids for Graves’ Ophthalmopathy: Systematic Review and Meta-Analysis
Joint Authors
Tu, Xiaofang
Dong, Yan
Zhang, Hongmei
Su, Qing
Source
Issue
Vol. 2018, Issue 2018 (31 Dec. 2018), pp.1-9, 9 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2018-11-22
Country of Publication
Egypt
No. of Pages
9
Main Subjects
Abstract EN
Background.
Graves’ ophthalmopathy (GO) is a complicated autoimmune disease.
Various therapies have been used to manage GO; however the optimum therapy is not clear.
Glucocorticoids (GCs) therapy is the mainstay of treatment especially for active moderate to severe patients, which needs evidence-based support.
Method.
We searched all the randomized controlled trials (RCTs) involving corticosteroid treatment for patients diagnosed with GO from EMBASE, Medline, and the Cochrane library and then conducted a system review and meta-analysis.
The electronic search covered the period from April 1966 to March 2018.
Result.
Twenty-nine trials were included.
GCs were proved to be beneficial for GO patients [response rate, risk ratio (RR) = 1.72, 95% confidence interval (CI): 1.28~2.31, P=0.0003], and intravenous corticosteroids worked significantly better than oral corticosteroids as ever reported.
When compared with the single treatment of GCs, the combination of radiotherapy and GCs showed similar effects on response rate (RR=1.25, 95%CI: 0.91~1.73).
A study proved the advantage of mycophenolate mofetil over GCs in three outcomes (response rate, RR=0.74, 95%CI: 0.63~0.88).
Additional treatments such as technetium-99 methylene diphosphate (99Tc-MDP) or cyclosporine enhanced the effect of GCs on proptosis reduction, respectively (P<0.00001 and P=0.02).
Conclusion.
Our meta-analysis confirmed the effects of GCs in the management of GO and intravenous GCs are proved to be better than oral GCs as ever reported.
Combination of radiotherapy and GCs did not enhance the effects of GCs.
However, if proptosis is the main issue, combination of 99Tc-MDP or cyclosporine with GCs may be taken into consideration.
The reported advantages of mycophenolate mofetil over GCs are noteworthy and need more RCTs to confirm.
American Psychological Association (APA)
Tu, Xiaofang& Dong, Yan& Zhang, Hongmei& Su, Qing. 2018. Corticosteroids for Graves’ Ophthalmopathy: Systematic Review and Meta-Analysis. BioMed Research International،Vol. 2018, no. 2018, pp.1-9.
https://search.emarefa.net/detail/BIM-1126946
Modern Language Association (MLA)
Tu, Xiaofang…[et al.]. Corticosteroids for Graves’ Ophthalmopathy: Systematic Review and Meta-Analysis. BioMed Research International No. 2018 (2018), pp.1-9.
https://search.emarefa.net/detail/BIM-1126946
American Medical Association (AMA)
Tu, Xiaofang& Dong, Yan& Zhang, Hongmei& Su, Qing. Corticosteroids for Graves’ Ophthalmopathy: Systematic Review and Meta-Analysis. BioMed Research International. 2018. Vol. 2018, no. 2018, pp.1-9.
https://search.emarefa.net/detail/BIM-1126946
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1126946