Endocrine Abstracts

Aim: The aim of this retrospective study was to assess the efficacy of different doses of rituximab (RTX) in patients with active moderate-severe Graves’ Orbitopathy (GO).Methods: Overall 40 patients, 5 M/35 F; mean age (± S.D.) 58±11 years were treated with RTX; 21 were smokers. The patients received the following treatment: 14 patients (group 1) a single 100 mg dose; 15 patients (group 2) a single 500 mg dose and 11 Patien...

Previous studies have shown that Rituximab (RTX) is effective as a disease modifying drug at doses of 500 mg or 1000×2 mg in active Graves’ orbitopathy (GO). We have conducted a pilot study (EUDRACT 2012-001980-53) in which patients with active moderate-severe GO were treated with a single infusion of low dose RTX (100 mg). Ten patients were enrolled of whom seven completed the study at 52 weeks. Five patients did not respond to a previous treatment with i.v. methylp...

Dysthyroid optic neuropathy (DON) is a sight threatening complication occurring in 3–5% patients with Graves’ orbitopathy. The medical treatment consists in the infusion of high dose of methylprednisolone (MP), while surgical orbital decompression is mandatory in patients non responding to the medical treatment. We aimed at studying the response to high dose steroids in DON and parameters for predicting therapy effectiveness. Twenty-three patients with DON were studi...

In assessing TAO, orbital CT scan allows measurement of extraocular muscle and optic nerve dimensions but it is useful mainly for a qualitative analysis and cannot be used in the clinical score of the disease. Aim of the present study was to seek a number which could express the expansion of the orbital tissue and be used in grading the severity of TAO. 39 TAO patients and 24 control subjects were studied. We have measured the orbital area (OA) on the central axial section of ...

We are conducting an open study on the treatment of Graves’ disease (GD) and thyroid-associated ophthalmopathy (TAO) with the monoclonal antibody to CD-20, rituximab (RTX) (MabThera, Hoffman-Roche, Basel). RTX induces depletion of B cells and GD is typically a B cell dependent autoimmune disease. We present preliminary results on 7 patients with GD and TAO at different clinical stages: 3 women with newly diagnosed GD and initial TAO; 1 woman with GD and moderate-severe TA...

Background: BAFF is a Serum B cell stimulating factor shown elevated in Graves’ disease, compared to controls (Vannucchi 2012). BAFF and its receptor are expressed on lymphocytes infiltrating the thyroid in Graves’ disease as well as on thyrocytes themselves (Campi 2015).Aims: A single-blind randomized controlled trial (EudraCT 2015-002127-26) has been conducted to test the efficacy of the anti-BAFF monoclonal antibody belimumab (BMB) in acti...

BAFF, a member of the TNF family, promotes autoantibody production by increasing B cell survival and proliferation. We have previously shown that serum BAFF concentrations are increased in GD patients. In the present work, we studied the expression of BAFF and BAFF-R, by immunohistochemistry (IHC) on paraffin embedded sections of: 1. orbital adipose tissue from 22 patients (5 men, 17 women) with GO (3 of them with active GO) associated with GD or Hashimoto thyroiditis in 19 an...

The anti-CD20 antibody Rituximab (RTX) induces peripheral B cells depletion. Aim of the present study was to evaluate changes of lymphocytes after RTX therapy, administered at the dosage of 1000 mg twice at 2-week interval, in 10 patients with Graves’ disease, 8 of whom had associated ophthalmopathy (TAO). In all patients, we studied the standard immunophenotypic panel before therapy and monthly for up to 2 years. Total CD20+ (and CD19+) cell depletion was observed after ...

We previously described a significant response to RTX treatment in patients with active TAO, with no effect on TRAb and hyperthyroidism. In order to study the effect of RTX in the orbit, we analyzed the orbital tissues of 9 patients with TAO at decompression after RTX (n.2) or other treatments. Decompression was carried out in 2 patients for sight threatening optic neuropathy and in 7 for correction of proptosis. Of the RTX treated patients, one was decompressed after 12 month...

BackgroundSerum B cell stimulating factor (BAFF) has been shown to be elevated in Graves’ disease (Vannucchi 2012). In addition, BAFF and its receptor have been shown to be expressed on lymphocytes infiltrating the thyroid in Graves’ disease and also on thyrocytes (Campi 2015).AimsWe tested in a single-blind randomized controlled trial (EudraCT 2015–002127–26) whether the administration ...