Factors Predicting Long-term Outcome and the Need for Surgery in Graves Orbitopathy: Extended Follow-up From the CIRTED Trial
Authors' conclusion
In this long-term follow-up from a clinical trial, 3-year outcomes remained suboptimal with ongoing poor quality of life and high numbers requiring surgery. Importantly, reduction in CAS in the first year, a commonly used surrogate outcome measure, was not associated with improved long-term outcomes.
Study context
- Population
- Patients with Graves orbitopathy randomized in the CIRTED trial, subset with 3-year dataof 126 randomized (54%)
- Participants
- 68 patients
- Comparison
- Azathioprine/placebo and radiotherapy/sham radiotherapy, with high-dose oral steroid
Methodological detailsextended follow-up, 3-year follow-up of a subset
- Extended follow-up
- 3-year follow-up of a subset
Primary result
As reported in the abstract
Long-term outcomes: BCCOM, modified EUGOGO score, Ophthalmopathy Index · 3 years
- No additional benefit at 3 years for azathioprine or radiotherapy for binary clinical composite outcome measure (BCCOM), modified European Group on Graves' Orbitopathy score, or Ophthalmopathy Index
Further findings
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Disease duration >6 months before treatment and need for surgeryDisease duration >6 monthsvs Disease duration ≤6 monthsIncreased need for surgery | 16.8 (2.95–95.0) | P = 0.001 | |
| 0.050.21520Odds ratio (log scale) |
CAS, Ophthalmopathy Index and Total Eye Score over 3 years
- Improved over 3 years
- P < 0.001
Quality of life · 3 years
- Quality of life remained poor
Surgical intervention required
- Required surgery
- 24 of 64 (37.5%)
- 64 with available surgical outcome data
Baseline predictors of surgery
- Higher baseline CAS, Ophthalmopathy Index and Total Eye Score, but not early improvement in CAS, associated with increased requirement for surgery
Original publication
Factors Predicting Long-term Outcome and the Need for Surgery in Graves Orbitopathy: Extended Follow-up From the CIRTED Trial. J Clin Endocrinol Metab. Published 27 March 2023. doi:10.
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