Abstract

Purpose: The purpose of this study is to examine the effectiveness of introducing both rituximab (RTX) and <sup>131</sup>I for active Graves' ophthalmopathy (GO) with hyperthyroidism. Methods: In total, 217 patients suffering from active GO with hyperthyroidism were included in this research. All subjects were randomly assigned to 3 groups. Patients in group A solely received <sup>131</sup>I treatment; group B1 underwent a methylprednisolone treatment in combination with <sup>131</sup>I treatment; and group B2 received an RTX in combination with <sup>131</sup>I treatment. Hyperthyroidism treatment outcomes, orbital volumetry, ophthalmic assessments, serum cytokine levels, and adverse effects were measured after treatment. Results: The orbital volumetry principle was significantly different from 24 weeks after the start of treatment among all 3 groups, and improvements in most ophthalmic parameters were regarded significantly different among 3 groups (all p < 0.05). The expression levels of miR-146a and most serum cytokines were regarded significantly different from 24 weeks after the start of treatment among 3 groups (all p < 0.05). Conclusions: In comparison with other therapies, RTX treatment in combination with <sup>131</sup>I treatment is considered to be more effective for hyperthyroidism with active GO.

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