File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)
Supplementary

Article: The effect of somatostatin versus corticosteroid in the treatment of Graves' ophthalmopathy

TitleThe effect of somatostatin versus corticosteroid in the treatment of Graves' ophthalmopathy
Authors
Issue Date1996
PublisherMary Ann Liebert, Inc Publishers. The Journal's web site is located at http://www.liebertpub.com/thy
Citation
Thyroid, 1996, v. 6 n. 5, p. 381-384 How to Cite?
AbstractUncontrolled study has demonstrated the usefulness of somatostatin in the treatment of mild Graves' ophthalmopathy (GO). We performed a prospective study to evaluate the usefulness of somatostatin as compared to corticosteroid in the treatment of moderately severe GO. All patients were rendered euthyroid and observed for 3 mouths to exclude spontaneous improvement without active treatment. They were randomized to receive either somatostatin (SS, octreotide 200 μg q8h subcutaneously, n = 8) or corticosteroid (CS, prednisone 1 mg/kg/day in decreasing doses, n = 10). Assessments of soft tissue inflammation, exophthalmos, palpebral aperture, intraocular pressure, diplopia, cornea, and visual acuity were made every 4 weeks for 3 months. MRI of the orbit was performed before and after treatment. Both SS and CS therapy decreased the palpebral aperture and activity score after 3 months (p < 0.05), but those treated with CS had a lower activity score after treatment when compared to SS [2.5 (1-7) v.s. 3.5 (0-4), median (range), p < 0.05]. Only CS, but not SS, was able to reduce intraocular pressure and muscle size as documented by MRI, but no significant reduction in proptosis was observed in either group. Also, patients' self- assessments of the eye changes after treatment were similar between the two groups. Both groups showed significant elevation of urinary glycosaminoglycau (GAG) excretion before therapy (SS 24.6 ± 10.8; CS 27.8 ± 11.4 mg/24 h), which was reduced after treatment (SS 12.5 ± 7.3; CS 10.8 ± 6.3 mg/24 h, p < 0.05). However, no significant correlation could be observed between the degree of GAG reduction and the clinical outcome of the patients. In conclusion, the long acting SS octreotide was effective in reducing soft tissue inflammation and providing symptomatic relief in GO but not as effective as corticosteroid in reducing muscle size. In view of the minimal side-effects and similar efficacy as compared to corticosteroid in patients with minimal extraocular muscle enlargement, it is suggested that a trial of SS may be considered in selected patients with GO.
Persistent Identifierhttp://hdl.handle.net/10722/162140
ISSN
2015 Impact Factor: 3.784
2015 SCImago Journal Rankings: 1.458
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorKung, AWCen_US
dc.contributor.authorMichon, Jen_US
dc.contributor.authorTai, KSen_US
dc.contributor.authorChan, FLen_US
dc.date.accessioned2012-09-05T05:17:35Z-
dc.date.available2012-09-05T05:17:35Z-
dc.date.issued1996en_US
dc.identifier.citationThyroid, 1996, v. 6 n. 5, p. 381-384en_US
dc.identifier.issn1050-7256en_US
dc.identifier.urihttp://hdl.handle.net/10722/162140-
dc.description.abstractUncontrolled study has demonstrated the usefulness of somatostatin in the treatment of mild Graves' ophthalmopathy (GO). We performed a prospective study to evaluate the usefulness of somatostatin as compared to corticosteroid in the treatment of moderately severe GO. All patients were rendered euthyroid and observed for 3 mouths to exclude spontaneous improvement without active treatment. They were randomized to receive either somatostatin (SS, octreotide 200 μg q8h subcutaneously, n = 8) or corticosteroid (CS, prednisone 1 mg/kg/day in decreasing doses, n = 10). Assessments of soft tissue inflammation, exophthalmos, palpebral aperture, intraocular pressure, diplopia, cornea, and visual acuity were made every 4 weeks for 3 months. MRI of the orbit was performed before and after treatment. Both SS and CS therapy decreased the palpebral aperture and activity score after 3 months (p < 0.05), but those treated with CS had a lower activity score after treatment when compared to SS [2.5 (1-7) v.s. 3.5 (0-4), median (range), p < 0.05]. Only CS, but not SS, was able to reduce intraocular pressure and muscle size as documented by MRI, but no significant reduction in proptosis was observed in either group. Also, patients' self- assessments of the eye changes after treatment were similar between the two groups. Both groups showed significant elevation of urinary glycosaminoglycau (GAG) excretion before therapy (SS 24.6 ± 10.8; CS 27.8 ± 11.4 mg/24 h), which was reduced after treatment (SS 12.5 ± 7.3; CS 10.8 ± 6.3 mg/24 h, p < 0.05). However, no significant correlation could be observed between the degree of GAG reduction and the clinical outcome of the patients. In conclusion, the long acting SS octreotide was effective in reducing soft tissue inflammation and providing symptomatic relief in GO but not as effective as corticosteroid in reducing muscle size. In view of the minimal side-effects and similar efficacy as compared to corticosteroid in patients with minimal extraocular muscle enlargement, it is suggested that a trial of SS may be considered in selected patients with GO.en_US
dc.languageengen_US
dc.publisherMary Ann Liebert, Inc Publishers. The Journal's web site is located at http://www.liebertpub.com/thyen_US
dc.relation.ispartofThyroiden_US
dc.subject.meshAdulten_US
dc.subject.meshFemaleen_US
dc.subject.meshGlucocorticoids - Therapeutic Useen_US
dc.subject.meshGlycosaminoglycans - Urineen_US
dc.subject.meshGraves Disease - Drug Therapy - Physiopathology - Urineen_US
dc.subject.meshHormones - Therapeutic Useen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshOctreotide - Therapeutic Useen_US
dc.subject.meshPrednisone - Therapeutic Useen_US
dc.subject.meshProspective Studiesen_US
dc.titleThe effect of somatostatin versus corticosteroid in the treatment of Graves' ophthalmopathyen_US
dc.typeArticleen_US
dc.identifier.emailKung, AWC:awckung@hku.hken_US
dc.identifier.authorityKung, AWC=rp00368en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1089/thy.1996.6.381-
dc.identifier.pmid8936659-
dc.identifier.scopuseid_2-s2.0-0029909390en_US
dc.identifier.hkuros22845-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0029909390&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume6en_US
dc.identifier.issue5en_US
dc.identifier.spage381en_US
dc.identifier.epage384en_US
dc.identifier.isiWOS:A1996VT66700002-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridKung, AWC=7102322339en_US
dc.identifier.scopusauthoridMichon, J=16939538600en_US
dc.identifier.scopusauthoridTai, KS=16940340000en_US
dc.identifier.scopusauthoridChan, FL=16938223600en_US

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats