The Efficacy of Rituximab Combined with ¹³¹I for Ophthalmic Outcomes of Graves' Ophthalmopathy Patients

Abstract

Purpose: The purpose of this study is to examine the effectiveness of introducing both rituximab (RTX) and ¹³¹I for active Graves' ophthalmopathy (GO) with hyperthyroidism. Methods: In total, 217 patients suffering from active GO with hyperthyroidism were included in this research. All subjects were randomly assigned to 3 groups. Patients in group A solely received ¹³¹I treatment; group B1 underwent a methylprednisolone treatment in combination with ¹³¹I treatment; and group B2 received an RTX in combination with ¹³¹I treatment. Hyperthyroidism treatment outcomes, orbital volumetry, ophthalmic assessments, serum cytokine levels, and adverse effects were measured after treatment. Results: The orbital volumetry principle was significantly different from 24 weeks after the start of treatment among all 3 groups, and improvements in most ophthalmic parameters were regarded significantly different among 3 groups (all p < 0.05). The expression levels of miR-146a and most serum cytokines were regarded significantly different from 24 weeks after the start of treatment among 3 groups (all p < 0.05). Conclusions: In comparison with other therapies, RTX treatment in combination with ¹³¹I treatment is considered to be more effective for hyperthyroidism with active GO.

Efficacy and Safety of Rituximab for the Treatment of Graves' Orbitopathy: A Meta‐analysis of Randomized Controlled Trials

“…Of those, 19 were not RCTs, 21 were reviews, eight evaluated different comparisons, four were animal studies, and one was a clinical practice guideline. Thus, four trials were eligible for inclusion in this meta‐analysis …”

“…The methodologic quality of the included trials is summarized in Table . All four studies reported acceptable methods of randomization . Two studies did not describe the blinding of patients and outcome assessors .…”

“…All four studies reported acceptable methods of randomization . Two studies did not describe the blinding of patients and outcome assessors . One study reported a loss to follow‐up rate of 20%; however, detailed explanations were provided .…”

“…One study reported a loss to follow‐up rate of 20%; however, detailed explanations were provided . The number of patients lost to follow‐up was acceptable (< 20%) in all other studies . Finally, reporting bias may have been introduced in one study because the statistics provided were unclear …”

“…RTX has been successfully used for treating autoimmune disorders such as rheumatoid arthritis and systemic lupus erythematosus . Several randomized controlled trials (RCTs) have recently investigated the efficacy of RTX for the treatment of GO . However, the outcomes of these trials varied and are thus inconclusive.…”