Fatal and non-fatal adverse events of glucocorticoid therapy for Graves' orbitopathy: A questionnaire survey among members of the European Thyroid Association

99Citations
Citations of this article
49Readers
Mendeley users who have this article in their library.

Abstract

Objective: The objective of this study was to investigate the side effects of glucocorticoid (GC) therapy observed by European thyroidologists during the treatment of Graves' orbitopathy (GO). Design: A questionnaire-based survey among members of the European Thyroid Association (ETA) who treat GO. Results: A response was obtained from 128 ETA members of which 115 used GC therapy for GO. The majority of respondents (83/115, 72%) used intravenous (i.v.) GC, with a relatively wide variety of therapeutic regimens. The cumulative dose of methylprednisolone ranged between 0.5 and 12 g (median 4.5 g) for i.v.GC and between 1.0 and 4.9 g (median 2.4 g) for oral GC. Adverse events were often reported during oral GCs (26/32, 81%); most side effects were non-severe, but ten respondents reported severe adverse events (hepatic, cardiovascular, and cerebrovascular complications), including two fatal cases, both receiving a total of 2.3 g prednisone. Adverse events were less common in i.v.GC (32/83 respondents, 39%), but mostly consisted of severe events, including seven fatal cases. All but one fatal event occurred in cumulative i.v.GC doses (> 8 g) higher than those currently recommended. Conclusions: GCs are preferentially administered i.v. for the treatment of GO in Europe. Both oral and i.v.GC may be associated with severe adverse effects, including fatal cases, which are more frequently reported in daily or alternate day i.v.GC. IvGC therapy should be undertaken in centers with appropriate expertise. Patients should be carefully examined for risk factors before treatment and monitored for side effects, which may be asymptomatic, both during and after treatment. © 2012 European Society of Endocrinology.

Cite

CITATION STYLE

APA

Marcocci, C., Watt, T., Altea, M. A., Rasmussen, A. K., Feldt-Rasmussen, U., Orgiazzi, J., & Bartalena, L. (2012). Fatal and non-fatal adverse events of glucocorticoid therapy for Graves’ orbitopathy: A questionnaire survey among members of the European Thyroid Association. European Journal of Endocrinology, 166(2), 247–253. https://doi.org/10.1530/EJE-11-0779

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free