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Treatment with a long-acting form of octreotide is not beneficial in patients with Graves’ eye disease
The background of the study. Graves’ eye
disease (ophthalmopathy) is caused by inflammation of the fatty
tissue and muscle behind the eyes. These tissues contain receptors
for somatostatin, which when stimulated by somatostatin might decrease
the inflammation. In this study, the efficacy of a long-acting somatostatin-like
substance (octreotide-LAR was evaluated in a group of these patients.
How the study was done. The study subjects were 51 patients with Graves’ eye disease, as defined by mild or moderate eyelid retraction, eyelid edema, eye protrusion (proptosis), impaired eye mobility, and enlarged eye muscles. At the start of the study, most were taking an antithyroid drug or thyroxine. All had normal thyroid function throughout the study. They were randomly assigned to treatment with octreotide-LAR or placebo, given intramuscularly once monthly for four months. They were evaluated at base line, monthly during the four-month treatment period, and at six months. The primary end point was improvement in the severity of ophthalmopathy, and secondary end points were changes in the extent of inflammation or proptosis and quality of life.
The results of the study. Forty-seven patients completed the study. There was no difference in the frequency of improvement at the end of treatment or at the end of the study in either group. The activity score decreased slightly in both groups. There was little overall change in proptosis; it decreased slightly at the end of treatment in one patient in each group and at the end of the study in four patients in the octreotide-LAR group and one patient in the placebo group. There were no changes in quality of life in either group.
The conclusions of the study. In patients with mild or moderate Graves’ eye disease, octreotide-LAR therapy for four months was not more effective than placebo.
The original article. Wemeau JL, Caron P, Beckers
A, Rohmer V, Orgiazzi J, Borson-Chazot F, Nocaudie M, Perimenis
P, Bisot-Locard S, Bourdeix I, Dejager S. Octreotide (long-acting
release formulation) treatment in patients with Graves’ orbitopathy:
clinical results of a four-month, randomized, placebo-controlled,
double-blind study. J Clin Endocrinol Metab 2005;90:841-8.
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| Thyroid Digest Index | | | July 2005 Thyroid Digest |
