اعتلال العين الدرقي النشط المتوسط إلى الشديد في مرض غريفز — الإدارة من الخط التالي بعد الجلوكوكورتيكويدات الوريدية

References

DOI: 10.1016/j.ecl.2021.12.004.

Intravenous glucocorticoids (IVGC) are considered first-line therapy in patients with moderate-to-severe TED.

The 2021 EUGOGO Clinical Practice Guidelines recommend combined use of IVGC and mycophenolate as first line therapy for active moderate-severe TED.

Teprotumumab is administered intravenously every 3 weeks (10 mg/kg first dose, then 20mg/kg) for a total of 8 infusions.

Dosing is 8 mg/kg at four monthly infusions.

A randomized trial of 32 patients with moderate-to-severe corticosteroid-resistant TED randomly assigned patients to tocilizumab (8 mg/kg) or placebo, administered intravenously at weeks 0, 4, 8, and 12.

For treatment of TED, two infusions of rituximab (1000 mg each and 2 weeks apart) have been utilized without immunosuppressive effects.

In the first trial, improvement of CAS by ≥ 2 points and reduction in proptosis by ≥ 2 mm, together, occurred in 69% of patients with teprotumumab versus 20% with placebo.

View source ↗