Abstract: Background: The response to treatment in adult patients suffering from thyroid-eye-disease is variable, with resistant and relapsing cases. Clinical and therapeutic factors involved are not well established. Objectives: To identify clinical determinants of favourable outcome in a sample of adults with active thyroid orbitopathy who received multidisciplinary treatment and to evaluate the effect of long duration treatment approaches for moderate-to-severe cases. Methods: This retrospective observational study included patients treated in a hospital environment with a follow-up of more than 1 year. The criteria for a favourable outcome after treatment were a final Clinic Activity Score (CAS) < 2 and fewer than 3 posttreatment visits with a CAS > 1. The treatments used for moderate-to-severe orbitopathy were categorized according to duration. The following were considered long-duration treatments (LDTs): radiotherapy combined with intravenous corticosteroids; and tocilizumab. These LDTs were compared with treatments that were administered for up to 3 months. Fisher’s and Mann‒Whitney tests were used to verify relationships between qualitative and quantitative variables. Logistic and linear regressions were used to predict dichotomous and numerical variables. Results: Seventy-two patients were included in the study. Active smoking and sustained endocrine disease were associated with a longer duration of active orbitopathy (p = 0.045 and p <0.001, respectively). Radioiodine-induced hypothyroidism and arterial hypertension were negatively correlated with a favourable outcome event, with ORs of 0.12 (p = 0.008) and 0.16 (p = 0.019), respectively. LDTs were determinants of favourable outcome, with an odds ratio of 6.85 (p = 0.015). LDTs also led to a greater decrease in the CAS (p = 0.03). Conclusion: Active smoking, radioiodine-induced hypothyroidism, arterial hypertension, and sustained endocrine disease are associated with non-favourable outcome after treatment. LDTs contribute to favourable outcomes in adult patients with active moderate-to severe thyroid ophthalmopathy.
Abstract: Background: The response to treatment in adult patients suffering from thyroid-eye-disease is variable, with resistant and relapsing cases. Clinical and therapeutic factors involved are not well established. Objectives: To identify clinical determinants of favourable outcome in a sample of adults with active thyroid orbitopathy who received multidi...Show More