Factors Associated with Response to Intravenous Glucocorticoids in Active Moderate-to-Severe Thyroid Eye Disease
Authors' conclusion
Older age and higher CAS before treatment were associated with poorer response to IVGC.
Study context
- Population
- Patients with active moderate-to-severe thyroid eye disease (TED) without dysthyroid optic neuropathy, treated 2003–2023 with the 12-week IVGC EUGOGO protocol; mean age 51.7 ± 11 years, 73.5% women44 also assessed by EUGOGO CI
- Participants
- 64 patients
- Exposure
- Responders vs nonresponders to IVGC
- Outcome
- Response to IVGC by clinical judgment (CL) and by EUGOGO 2021 revised composite index (CI)
- Follow-up
- 6 months after IVGC
Methodological detailssingle tertiary centre
- Single tertiary centre
Main finding
As reported in the abstract
Factors independently associated with response to IVGC (multivariable logistic regression)
- Age at IVGC initiation, CL: OR 0.92 (95% CI 0.86-0.99), p = 0.024
- Age at IVGC initiation, EUGOGO CI: OR 0.88 (CI 0.77-0.99), p = 0.046
- Clinical activity score (CAS) before IVGC, CL: OR 0.53 (CI 0.31-0.90), p = 0.021
- CAS before IVGC, EUGOGO CI: OR 0.08 (CI 0.01-0.38), p = 0.001
- Active smoking not an independent factor
Observational data: associations, not effects.
Further findings
Age (years), CL
P = 0.040 for CL
Age (years), EUGOGO CI
P = 0.131 for EUGOGO CI
| Outcome | Responders | Nonresponders | P value |
|---|---|---|---|
| CAS before IVGC, CL | 4.2 ± 1.1 | 5.0 ± 1.1 | P = 0.022 for CL |
| CAS before IVGC, EUGOGO CI | 3.1 ± 0.8 | 4.7 ± 0.6 | P < 0.001 for EUGOGO CI |
Response rate · 6 months after IVGC
- Responders by CL
- 48 out of 64 (75%)
- Responders by EUGOGO CI
- 32 out of 44 (73%)
Optimal CAS cut-off for poorer response
- CL: CAS ≥4.5/7, 66.7% specificity, 56.3% sensitivity; AUC 0.689 (CI 0.54-0.83), p = 0.010
- EUGOGO CI: CAS ≥3.5/5, 65.6% specificity, 91.7% sensitivity; AUC 0.910 (CI 0.80-1.01), p < 0.001
Original publication
Factors Associated with Response to Intravenous Glucocorticoids in Active Moderate-to-Severe Thyroid Eye Disease. Thyroid. Published 7 March 2025. doi:10.
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