Comparison of the Effectiveness of Two Glucocorticoid Regimens for Treatment of Graves' Orbitopathy

NCT ID: NCT05793359

Last Updated: 2023-03-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

62 participants

Study Classification

OBSERVATIONAL

Study Start Date

2017-07-25

Study Completion Date

2021-02-25

Brief Summary

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The goal of this interventional study is to compare the effectiveness of two different glucocorticoid regimens for treatment of active moderate-to-severe Graves' orbitopathy. The main questions it aims to answer are:

1. Are the two glucocorticoid regimens similarly effective?
2. Do the two glucocorticoid regimens have similar safety profile? The patients involved are treated with one of the two glucocorticoid regimens. Their ocular status, therapeutic response and quality of life reassessed during the treatment, at its end, and 3 month later.

Detailed Description

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Systemic glucocorticoids are the mainstay of treatment for active moderate-to-severe Graves' orbitopathy. However, there are a number of different glucocorticoid regimens with different total dosage, schemes of administration and duration. The goal of this interventional study is to compare the effectiveness of two different glucocorticoid regimens for treatment of active moderate-to-severe Graves' orbitopathy. The main questions it aims to answer are:

1. Are the two glucocorticoid regimens similarly effective?
2. Do the two glucocorticoid regimens have similar safety profile? The patients involved are treated with one of the two glucocorticoid regimens. The first group is treated with modified monthly regimen, including 3 pulses of 3 infusions of 500 mg methylprednisolone administered in three consecutive months, with application of 125 mg methylprednisolone intramuscularly once per week between the pulses. Total cumulative dose - 5.5. g., duration - 3 months. After completion of the venous infusions, a low dose peroral glucocorticoid therapy is prescribed for the next 3 months. The second group is treated with weekly glucocorticoid regimen: 6 infusions of 500 mg methylprednisolone during the first 6 weeks followed by 6 infusions of 250 mg methylprednisolone during the next 6 weeks. Total cumulative dose - 4.5 g., duration - 3 months. Patients' ocular status and therapeutic response are assessed at 1st, 3rd and 6th months; quality of life - at 3rd and 6th month.

Conditions

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Graves Ophthalmopathy

Study Design

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Observational Model Type

OTHER

Study Time Perspective

PROSPECTIVE

Study Groups

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Modified monthly regimen

Treatment with 3 pulses of 3 infusions of 500 mg methylprednisolone on 3 consecutive months with intramuscular administration of 125 mg methylprednisolone per week between the pulses. Additional low dose peroral treatment after completion of the pulses.

Methylprednisolone

Intervention Type DRUG

methylprednisolone applied as intravenous infusions or intramuscularly

Weekly regimen

Treatment with 6 infusions of 500 mg methylprednisolone during the first 6 weeks, followed by 6 infusions of 250 mg methylprednisolone during the next 6 weeks.

Methylprednisolone

Intervention Type DRUG

methylprednisolone applied as intravenous infusions or intramuscularly

Interventions

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Methylprednisolone

methylprednisolone applied as intravenous infusions or intramuscularly

Intervention Type DRUG

Other Intervention Names

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Urbason

Eligibility Criteria

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Inclusion Criteria

* Active moderate-to-severe Graves' orbitopathy
* Without previous treatment with glucocorticoids or orbital radiotherapy
* Euthyroid state

Exclusion Criteria

* Uncontrolled hyper- or hypothyroidism
* Previously treated Graves' orbitopathy
* Mild or sight-threatening form of Graves' orbitopathy
* Inactive moderate-to-severe Graves' orbitopathy
* Contraindications for glucocorticoid treatment
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medical University of Sofia

OTHER

Sponsor Role lead

Responsible Party

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Mariya Stoynova

Principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Mariya D Stoynova, PhD

Role: PRINCIPAL_INVESTIGATOR

Medical University of Sofia: Medicinski universitet-Sofia

Locations

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University Hospital of Endocrinology

Sofia, , Bulgaria

Site Status

Countries

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Bulgaria

References

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Stoynova MA, Shinkov AD, Dimitrova ID, Yankova IA, Kovatcheva RD. Comparison of the efficacy of two different glucocorticoid regimens for treatment of active moderate-to-severe Graves' orbitopathy. Int Ophthalmol. 2023 Dec;43(12):4747-4757. doi: 10.1007/s10792-023-02875-z. Epub 2023 Sep 12.

Reference Type DERIVED
PMID: 37698660 (View on PubMed)

Other Identifiers

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21A /25.07.2017

Identifier Type: -

Identifier Source: org_study_id