Abstract
BackgroundThe current therapies of thyroid-associated ophthalmopathy (TAO) were still a challenging matter. In this study, we aimed to contrast the impact of before- after rituximab (RTX) therapy in the patients with TAO.MethodsWe searched the PubMed, EMBASE, and SCOPUS databases for articles published up to July 3, 2017. Fixed- or random-effects meta-analysis was used to provide pooled estimates of standard mean difference (SMD) both the primary outcome from clinical activity score (CAS), and secondary outcomes from thyrotropin receptor antibody (TRAb), proptosis, thyroid stimulating hormone (TSH), and interleukin-6 (IL-6) levels. In addition, the quality and each study was assessed using either the Newcastle Ottawa Scale (NOS) or the Cochrane Risk of Bias tool, and reliability of the meta-analytic result using the Grading of Recommendations Assessment, Development and Evaluation (GRADE).ResultsOf the 839 articles initially searched, 11 studies were finally eligible for inclusion. Subgroup analysis results showed that comparing with initial value, there was a decline in CAS at 1,3,6,12 month after RTX treatment, decreased TRAbs level at 6,12 month, proptosis improvement at least 1 month, unchanged IL-6 level at 6 month, decreased TSH level at 3 month but unchanged at 12 month. All included studies were classified as good quality.ConclusionsThe pooled data suggested that the preliminary effects of RTX treatment on TAO might be promising. However, more large-sample and high-quality studies targeting RTX use during this disease and long-term surveillance of prognosis are urgently needed.
Highlights
The current therapies of thyroid-associated ophthalmopathy (TAO) were still a challenging matter
One half of the participants were from China (44.9%), followed by Europe (31.7%) and North America (23.4%)
Methodological quality in included studies were acceptable by Newcastle-Ottawa Scale and Cochrane risk of bias tool, in which main drawbacks were the application of few blinding and random distribution, and insufficient sample size, which were reliable appraised through GRADE
Summary
The current therapies of thyroid-associated ophthalmopathy (TAO) were still a challenging matter. We aimed to contrast the impact of before- after rituximab (RTX) therapy in the patients with TAO. Thyroid-associated ophthalmopathy (TAO) is an autoimmune inflammatory orbital disease, which usually is caused by 20–50% of patients with Graves’ disease (GD) [1] and has the symptom of bilateral or unilateral eyeball protrusion, eyelid swelling, edema of periorbital tissue, and upper or lower eyelid retraction [2]. B cells could induce immune function via antigen presentation, co-stimulatory molecules expression and antibodies production. We did a systematic review and aimed to check whether the CAS activity improved 1 month or more after RTX treatment for persons with TAO
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
