Evaluation of methylprednisolone pulse therapy versus combined therapy with prednisolone and cyclosporine in the treatment of infiltrative ophthalmopathy in Graves' disease

Abstract

The study was undertaken to evaluate the efficiency of methylprednisolone pulse therapy versus combined therapy with prednisolone and cyclosporine in the treatment of Graves' infiltrative ophthalmopathy. Twenty-four euthyroid patients (15 females and 9 males) aged 28 to 71 years who had severe active ophthalmopathy were randomized into 2 groups. Group 1 patients received pulse therapy with methylprednisolone while Group 2 patients were treated with a combination of prednisolone and cyclosporine. The efficiency of therapy was evaluated by the changes in indices by the clinical activity score (CAS), soft tissue inflammation (STI), average exophthalmos, the dysfunction of extraocular muscles, the total diameter of extraocular muscles by the data of computed tomography 2 weeks before the initiation of therapy and 36 weeks after its discontinuation. Following 2-week therapy, the patients from both groups had lower CAS, diminished inflammatory soft tissue manifestations by the STI scale, and alleviated average exophthalmos. Thirty-six weeks after therapy discontinuation, the values returned to the baseline ones in Group 1 patients whereas the achieved positive effect is retained in Group 2 patients.