A 2018 European Thyroid Association Survey on the Use of Selenium Supplementation in Graves’ Hyperthyroidism and Graves’ Orbitopathy

Negro, Roberto; Attanasio, Roberto; Papini, Enrico; Winther, Kristian Hillert

doi:10.1159/000494837

Cited by 22 publications

(18 citation statements)

References 41 publications

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“…In the light of the above, and in order to better characterize the diffusion of MIT procedures into current European clinical practice, the ETA conducted a survey among its members. The sample size was thought to be representative, and as previous surveys originated from the responses of approximately 40-50% of the clinically active members of the ETA [27]. Most important, nearly all the respondents declared a specific expertise in the management of thyroid nodules.…”

Section: Discussionmentioning

confidence: 99%

European Thyroid Association Survey on Use of Minimally Invasive Techniques for Thyroid Nodules

Hegedűs¹,

Frasoldati²,

Negro³

et al. 2020

Eur Thyroid J

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Objective: Image-guided interventional ultrasound (US) techniques represent diagnostic and therapeutic tools for non-surgical management of thyroid nodular disease. We sought to investigate the attitude of European Thyroid Association (ETA) members towards the use of minimally invasive techniques (MIT) in diagnosis/therapy of symptomatic nodular goitre. Methods: ETA members were invited to participate in an online survey investigating the use of MIT in benign and malignant thyroid nodular disease. Of 865 invited members, 221 (25.5%) completed the survey. The respondents were from 40 countries; 139 (74.7%) were from European countries. Results: Respondents personally performed thyroid US (91.6%), Fine needle aspiration (FNA; 75.3%), ethanol ablation (EA; 22.1%), core needle biopsy (CNB; 11%) and thermal treatments (4.8%). When skills and/or technology were unavailable, only 13.4% referred patients "often" or "always" to other centres with specific expertise in this field. Surgery was the preferred first option in patients with recurrent cysts, 4.0 cm benign nodules, local (radioiodine-avid or non-avid) lymph node metastases, or papillary cancers < 1.0 cm. For autonomously functioning nodules radioactive iodine treatment was the preferred choice, followed by surgery. Thermal ablation (TA) was the preferred option only for a 4 cm benign nodule in old patients with comorbidities. Conclusions: US, US-guided FNA and surgery were available to nearly all respondents, while MIT was not. CNB and EA were employed only by about 1/3 of the respondents and TA procedures were available and personally performed only by a minority. For most thyroid lesions, surgery was the preferred option versus thermal therapies. The ETA needs to develop guidelines and establish teaching to overcome geographic inequality and promote the use of MIT as a valid therapy option in appropriate cases.

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Section: Discussionmentioning

confidence: 99%

European Thyroid Association Survey on Use of Minimally Invasive Techniques for Thyroid Nodules

Hegedűs¹,

Frasoldati²,

Negro³

et al. 2020

Eur Thyroid J

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“…Whether selenium administration is of benefit in selenium-replete areas has to be confirmed. An European survey has shown that selenium supplementation is recommended by the majority of clinicians, both in patients with mild and moderate-to-severe GO (75), but there is no evidence of a beneficial adjuvant effect of selenium in patients with moderateto-severe and active GO.…”

Section: Management Of Mild Gomentioning

confidence: 99%

The 2021 European Group on Graves’ orbitopathy (EUGOGO) clinical practice guidelines for the medical management of Graves’ orbitopathy

Bartalena

Kahaly

Baldeschi

et al. 2021

European Journal of Endocrinology

466

497

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Graves’ orbitopathy (GO) is the main extrathyroidal manifestation of Graves’ disease (GD). Choice of treatment should be based on assessment of clinical activity and severity of GO. Early referral to specialized centers is fundamental for most patients with GO. Risk factors include smoking, thyroid dysfunction, high serum level of thyrotropin receptor antibodies, radioactive iodine (RAI) treatment, and hypercholesterolemia. In mild and active GO, control of risk factors, local treatments and selenium (selenium-deficient areas) are usually sufficient; if RAI treatment is selected to manage GD, low-dose oral prednisone prophylaxis is needed, especially if risk factors coexist. For both active moderate-to-severe and sight threatening GO, antithyroid drugs are preferred when managing Graves’ hyperthyroidism. In moderate-to-severe and active GO, intravenous (iv) glucocorticoids are more effective and better tolerated than oral glucocorticoids. Based on current evidence and efficacy/safety profile, costs and reimbursement, drug availability, long-term effectiveness and patient choice after extensive counselling, a combination of iv methylprednisolone and mycophenolate sodium is recommended as first-line treatment. A cumulative dose of 4.5 grams (g) of iv methylprednisolone in 12 weekly infusions is the optimal regimen. Alternatively, higher cumulative doses not exceeding 8 g can be used as monotherapy in most severe cases and constant/inconstant diplopia. Second-line treatments for moderate-to-severe and active GO include: a) a second course of iv methylprednisolone (7.5 g) subsequent to careful ophthalmic and biochemical evaluation, b) oral prednisone/prednisolone combined with either cyclosporine or azathioprine; c) orbital radiotherapy combined with oral or iv glucocorticoids, d) teprotumumab; e) rituximab and f) tocilizumab. Sight threatening GO is treated with several high single doses of iv methylprednisolone per week and, if unresponsive, with urgent orbital decompression. Rehabilitative surgery (orbital decompression, squint and eyelid surgery) is indicated for inactive residual GO manifestations.

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“…49% респондентов ответили, что назначают Se пациентам с заболеваниями ЩЖ редко (от случая к случаю), 21%часто/всегда, 21 %никогда. При ответе на вопрос о достаточной обоснованности такого рода терапии при АИТ, 41% респондентов ответил, что терапия является необоснованной, но тем не менее периодически они ее назначают своим пациентам, 20 % считают терапию обоснованной и назначают её всегда [14].…”

Section: обсуждение основного результата исследованияunclassified

Effects of selenium in patients with autoimmune thyroiditis

et al. 2019

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Background: In the last decades, a number of clinical studies have been conducted where both the positive and neutral effects of Se on thyroid autoimmunity have been demonstrated. Aims: The aim of our study was to assess the effects of selenmethionine among euthyroid patients with elevated TPO-Ab (TPO > 100 IU/ml) and patients with subclinical hypothyroidism and elevated TPO-Ab. Materials and methods: 40 euthyroid patients with elevated TPO-Ab and 11 patients with subclinical hypothyroidism plus elevated TPO-Ab were included in our study. Patients of both categories were randomized to recieve Se 200 μg/day or to the dynamic observation. TSH, f. T4, f. T3, AT-TPO were measured at baseline and every 3 months of follow-up. The volume and echogenicity of the thyroid were also evaluated every 3 month of follow-up period (12 month). Results: There were no significant difference between the groups on the dynamics of TSH, f. T3, f. T4, AT-TPO titers, volume and the echogenicity of the thyroid gland during the whole observational period among euthyroid patients with elevated TPO-Ab. Among the patients with subclinical hypothyroidism there were also no significant difference between the groups on the dynamics of f. T3, f. T4, AT-TPO titers, volume and the echogenicity of the thyroid gland during the whole observational period. But by the 12 month of the follow-up there were significantly more euthyroid patients in Se group compare to dynamic observation group. Conclusions: Our study, failed to show possitive effects of Se supplementation on thyroid autoimmunity.

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A 2018 European Thyroid Association Survey on the Use of Selenium Supplementation in Graves’ Hyperthyroidism and Graves’ Orbitopathy

Cited by 22 publications

References 41 publications

European Thyroid Association Survey on Use of Minimally Invasive Techniques for Thyroid Nodules

European Thyroid Association Survey on Use of Minimally Invasive Techniques for Thyroid Nodules

The 2021 European Group on Graves’ orbitopathy (EUGOGO) clinical practice guidelines for the medical management of Graves’ orbitopathy

Effects of selenium in patients with autoimmune thyroiditis

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