Treatment of moderate to severe orbitopathy: Current modalities and perspectives |
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| Authors: | Nadia Bouzehouane Françoise Borson-Chazot Juliette Abeillon Philippe Caron |
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| Affiliation: | 1. Department of Endocrinology, Queen Mary University of London, E1 4NS London, United Kingdom;2. Department of Endocrinology, Saint-Bartholomew''s Hospital, EC1A 7BE London, United Kingdom;3. Department of Cardiology, University Hospitals Birmingham NHS Foundation Trust, B15 2GW Birmingham, United Kingdom;4. Institute of Cardiovascular Sciences, University of Birmingham, B15 2TT Birmingham, United Kingdom;1. Centre national de Référence des Pathologies Rares de l’Insulino- Sécrétion et de l’Insulino -Sensibilité (PRISIS), Service d’Endocrinologie, Diabétologie et Endocrinologie de la Reproduction, Hôpital Saint-Antoine, Assistance Publique–Hôpitaux de Paris, Paris, France;2. Sorbonne Université, Inserm UMR_S 938, Centre de Recherche Saint-Antoine (CRSA), Paris, France;3. Service de Cardiologie, Hôpital Saint-Antoine, Assistance Publique–Hôpitaux de Paris, Paris, France;4. Laboratoire Commun de Biologie et Génétique Moléculaires, Hôpital Saint-Antoine, Assistance publique–Hôpitaux de Paris, Paris, France;5. Université de Lille, CHU Lille, Service d’Endocrinologie, Diabétologie et Métabolisme, Inserm U1190, European Genomic Institute for Diabetes (EGID), Lille, France;6. Sorbonne Université, Inserm UMR_S970, FILNEMUS, Service de Cardiologie, Hôpital Cochin, Assistance Publique–Hôpitaux de Paris, Paris-Descartes, Paris Cardiovascular Research Centre (PARCC), Paris, France;2. Department of endocrine surgery, Hôpital Lyon Sud, 165, rue du grand Revoyet, 69495 Pierre-Bénite, France;3. Inserm U1290, Research on Healthcare Performance Lab (RESHAPE), Université Claude-Bernard Lyon 1, domaine Rockefeller, 8, avenue Rockefeller, 69003 Lyon, France;1. LEGOS, université Paris-Dauphine, place Maréchal-de-Lattre-de-Tassigny, 75116 Paris, France;2. Service d’endocrinologie, hôpital Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France;3. IQVIA (formerly Quintiles IMS), 17, place des Reflets, 92099 Paris La Défense, France;4. Laboratoire MSD, Medical and market access departments, Immeuble Carré Michelet, 10/12, Cours Michelet, 92800 Puteaux, France |
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| Abstract: | ![]()
Graves’ orbitopathy (GO) is the primary cause of exophthalmos in adults. It appears in 30 to 50% of patients with Graves’ disease. About 5% are moderate-to-severe cases that might be see-threatening or lead to long term disabling sequelae. Recommendations have been established in 2016 by the European thyroid association (ETA) and the European group on Grave's orbitopathy (EUGOGO), suggesting a wide use of corticosteroids in moderate to severe forms. However, disappointing results have been reported in 20 to 30% of cases. Improved understanding of pathophysiological mechanisms has allowed the use of non-specific immunomodulatory agents, currently under evaluation, and which place in the therapeutic strategy remains to be determined. Very recently, new promising therapeutic advances have emerged with the identification of new therapeutic targets, such as the TSH receptor and IGF-1 receptor complex. |
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| Keywords: | Graves’ orbitopathy Corticosteroid therapy Rituximab Tocilizumab Mycophenolate mofetil Teprotumumab Orbitopathie basedowienne Corticothérapie Rituximab Tocilizumab Mycophénolate mofetil Teprotumumab GO" },{" #name" :" keyword" ," $" :{" id" :" kw0070" }," $$" :[{" #name" :" text" ," _" :" Graves’ orbitopathy DON" },{" #name" :" keyword" ," $" :{" id" :" kw0080" }," $$" :[{" #name" :" text" ," _" :" Dysthyroid optic neuropathy |
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