Prognostic significance of thyroid-stimulating hormone receptor antibodies in moderate-to-severe graves’ orbitopathy
DesignRetrospective studyPurposeThe purpose of this retrospective study was to assess the changes in thyroid-stimulating hormone receptor (TSH-R) antibody levels following treatment in patients with moderate-to-severe and active Graves’ orbitopathy (GO) and to investigate the correlation between the...
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1153312/full |
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| author | Jungyul Park Jungyul Park Jaehyun Kim Sang Soo Kim Hee-Young Choi Hee-Young Choi |
| author_facet | Jungyul Park Jungyul Park Jaehyun Kim Sang Soo Kim Hee-Young Choi Hee-Young Choi |
| author_sort | Jungyul Park |
| collection | DOAJ |
| description | DesignRetrospective studyPurposeThe purpose of this retrospective study was to assess the changes in thyroid-stimulating hormone receptor (TSH-R) antibody levels following treatment in patients with moderate-to-severe and active Graves’ orbitopathy (GO) and to investigate the correlation between these antibodies and treatment response.MethodsThe subjects of this study comprised of patients newly diagnosed with moderate-to-severe and active GO within the age range of 19 to 79 years. All participants underwent intravenous methylprednisolone (IVMP) therapy for a duration of 12 weeks. Patients with a clinical activity score (CAS) decrease to or less than 3 and no symptom recurrence for at least 3months after the last dose of IVMP were classified as “Group 1”. Those with a CAS equal to or greater than 4 were classified as “Group 2”. TSH-R antibody levels were measured prior to and following IVMP treatment and treatment response was evaluated after the completion of IVMP therapy. All patients were monitored for a minimum of 6 months post-treatment, with ocular examinations and laboratory tests at the initial visit being included in the analysis.ResultsThe medical records of the 96 patients with GO were retrospectively reviewed. Seventy-five patients (78.1%) were response and 21 (21.9%) were non-responsive to IVMP treatment. A higher TSH-R antibody (TRAb) and thyroid-stimulating antibody (TSAb) following treatment were associated with a high risk of no treatment response (P = 0.017; P = 0.047, respectively). TRAb and TSAb levels before treatment were significantly related to TRAb and TSAb levels after treatment (P < 0.001, respectively). The cut-off values for the prediction of poor treatment response of the TRAb and TSAb before and after treatment were 8.305 IU/L, 5.035 IU/L and 449.5%, 361%, respectively (P = 0.027, P =0.001 and P = 0.136, P = 0.004, respectively).ConclusionIt was observed that elevated levels of TRAb and TSAb prior to IVMP treatment were positively correlated with post-treatment levels of these antibodies. Furthermore, in cases of non-response to IVMP therapy, a diminished decline in both antibodies was observed, and elevated levels of TRAb and TSAb post-treatment were found to be a significant predictor of poor treatment outcome. Measurement of TRAb and TSAb throughout the course of treatment in moderate-to-severe and active cases of GO may offer valuable insights into treatment prognosis and aid in the decision-making process regarding the potential need for increased IVMP dosage or alternative therapeutic strategies. |
| first_indexed | 2024-04-09T13:56:19Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-04-09T13:56:19Z |
| publishDate | 2023-05-01 |
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| series | Frontiers in Endocrinology |
| spelling | doaj.art-8c22c34080584f159873136f35bae4d82023-05-08T04:48:11ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-05-011410.3389/fendo.2023.11533121153312Prognostic significance of thyroid-stimulating hormone receptor antibodies in moderate-to-severe graves’ orbitopathyJungyul Park0Jungyul Park1Jaehyun Kim2Sang Soo Kim3Hee-Young Choi4Hee-Young Choi5Department of Ophthalmology, Pusan National University School of Medicine, Busan, Republic of KoreaBiomedical Research Institute, Pusan National University Hospital, Busan, Republic of KoreaDepartment of Ophthalmology, Pusan National University School of Medicine, Busan, Republic of KoreaDepartment of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of KoreaDepartment of Ophthalmology, Pusan National University School of Medicine, Busan, Republic of KoreaBiomedical Research Institute, Pusan National University Hospital, Busan, Republic of KoreaDesignRetrospective studyPurposeThe purpose of this retrospective study was to assess the changes in thyroid-stimulating hormone receptor (TSH-R) antibody levels following treatment in patients with moderate-to-severe and active Graves’ orbitopathy (GO) and to investigate the correlation between these antibodies and treatment response.MethodsThe subjects of this study comprised of patients newly diagnosed with moderate-to-severe and active GO within the age range of 19 to 79 years. All participants underwent intravenous methylprednisolone (IVMP) therapy for a duration of 12 weeks. Patients with a clinical activity score (CAS) decrease to or less than 3 and no symptom recurrence for at least 3months after the last dose of IVMP were classified as “Group 1”. Those with a CAS equal to or greater than 4 were classified as “Group 2”. TSH-R antibody levels were measured prior to and following IVMP treatment and treatment response was evaluated after the completion of IVMP therapy. All patients were monitored for a minimum of 6 months post-treatment, with ocular examinations and laboratory tests at the initial visit being included in the analysis.ResultsThe medical records of the 96 patients with GO were retrospectively reviewed. Seventy-five patients (78.1%) were response and 21 (21.9%) were non-responsive to IVMP treatment. A higher TSH-R antibody (TRAb) and thyroid-stimulating antibody (TSAb) following treatment were associated with a high risk of no treatment response (P = 0.017; P = 0.047, respectively). TRAb and TSAb levels before treatment were significantly related to TRAb and TSAb levels after treatment (P < 0.001, respectively). The cut-off values for the prediction of poor treatment response of the TRAb and TSAb before and after treatment were 8.305 IU/L, 5.035 IU/L and 449.5%, 361%, respectively (P = 0.027, P =0.001 and P = 0.136, P = 0.004, respectively).ConclusionIt was observed that elevated levels of TRAb and TSAb prior to IVMP treatment were positively correlated with post-treatment levels of these antibodies. Furthermore, in cases of non-response to IVMP therapy, a diminished decline in both antibodies was observed, and elevated levels of TRAb and TSAb post-treatment were found to be a significant predictor of poor treatment outcome. Measurement of TRAb and TSAb throughout the course of treatment in moderate-to-severe and active cases of GO may offer valuable insights into treatment prognosis and aid in the decision-making process regarding the potential need for increased IVMP dosage or alternative therapeutic strategies.https://www.frontiersin.org/articles/10.3389/fendo.2023.1153312/fullgraves' orbitopathyTSH-R antibodycut-off valueIVMP treatmenttreatment response |
| spellingShingle | Jungyul Park Jungyul Park Jaehyun Kim Sang Soo Kim Hee-Young Choi Hee-Young Choi Prognostic significance of thyroid-stimulating hormone receptor antibodies in moderate-to-severe graves’ orbitopathy Frontiers in Endocrinology graves' orbitopathy TSH-R antibody cut-off value IVMP treatment treatment response |
| title | Prognostic significance of thyroid-stimulating hormone receptor antibodies in moderate-to-severe graves’ orbitopathy |
| title_full | Prognostic significance of thyroid-stimulating hormone receptor antibodies in moderate-to-severe graves’ orbitopathy |
| title_fullStr | Prognostic significance of thyroid-stimulating hormone receptor antibodies in moderate-to-severe graves’ orbitopathy |
| title_full_unstemmed | Prognostic significance of thyroid-stimulating hormone receptor antibodies in moderate-to-severe graves’ orbitopathy |
| title_short | Prognostic significance of thyroid-stimulating hormone receptor antibodies in moderate-to-severe graves’ orbitopathy |
| title_sort | prognostic significance of thyroid stimulating hormone receptor antibodies in moderate to severe graves orbitopathy |
| topic | graves' orbitopathy TSH-R antibody cut-off value IVMP treatment treatment response |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1153312/full |
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