Smoking was associated with poor response to intravenous steroids therapy in Graves’ ophthalmopathy

Abstract

Smoking, even past smoking, was an independent risk factor associated with impaired response to intravenous corticosteroids in patients with GO. Smokers with GO should be given optimised treatment strategy such as higher dose of GC or combined radiation therapy.

Factors associated with the efficacy of intravenous methylprednisolone in moderate‐to‐severe and active thyroid‐associated ophthalmopathy: A single‐centre retrospective study

“…In addition, a large number (around 40%) of potential patients were excluded from this study (Figure 1), although the final sample size (302 patients) was still much larger than that of the similar investigations, 15,33,34 the present retrospective study may therefore be less generalizable.…”

“…[29][30][31][32] However, the impact of smoking on IVMP therapy remained controversial. A previous observational study of 92 patients showed that smoking, even passive smoking, was associated with poor therapeutic response to IVMP in TAO patients, 33 whereas a later retrospective study of 83 patients showed that smoking did not affect the long-term outcome of Graves' Ophthalmopathy following intravenous glucocorticoids therapy. 34 Another recent retrospective study of 90 patients reported that smoking was not associated with the efficacy of IVMP therapy.…”

“…Patients were dichotomized into those with TSH levels 34 Another recent retrospective study of 90 patients reported that smoking was not associated with the efficacy of IVMP therapy. 33 However, because of the retrospective design of this study, it was hard to judge whether each patient was a passive smoker or not, we classified patients as never smokers, ex-smokers and current smokers referencing several studies published in respected journals that divided participants into smokers (current smokers) and nonsmokers. A possible reason for this discrepancy might be the different methods for classifying smoking status.…”

“…*Statistically significant values with P < 0.05. oxidative stress and pro-inflammatory cytokines such as interleukin-6, tumour necrosis factor-α and IL-17A are involved in the pathogenesis of Graves' orbitopathy,27,28 it is possible that hyperlipidemia might aggravate this condition and thus negatively impact the therapeutic response. A previous observational study of 92 patients showed that smoking, even passive smoking, was associated with poor therapeutic response to IVMP in TAO patients,33 whereas a later retrospective study of 83 patients showed that smoking did not affect the long-term outcome of Graves' Ophthalmopathy following intravenous glucocorticoids therapy. The present findings may have important clinical implications as they may unravel a new field in the management of TAO patients.…”

Expression and clinical significance of connective tissue growth factor (CTGF) in Graves' ophthalmopathy

“…Cigarette smoking is known to affect the incidence and the severity in GO, as well as the course of GO during treatment 46 47. Cawood and colleagues further showed that cigarette smoke extract could increase glycosaminoglycan production and adipogenesis in GO fibroblasts 48.…”