Intravenous glucocorticoid (IVGC) is an accessible and effective therapy for Graves orbitopathy (GO); the 4.5-g weekly protocol is well studied, but many details of treatment protocols need to be clarified. The goal of this trial is to compare the efficacy and safety of weekly and daily protocol of IVGC in GO. Researchers will compare daily protocol to weekly protocol to see if daily protocol works to treat GO.
Age 18-65 years old;
diagnosed as thyroid associated ophthalmopathy by using Bartley criteria，Moderate to severe (EUGOGO grade), with CAS≥3 points;
Thyroid function normally lasts for more than 2 months, with oral antithyroid drugs or thyroid surgery, or six months after iodine-131 treatment;
without receiving immunosuppressive therapy for thyroid eye disease before.
None
Parallel
methylprednisolone(daily scheme)
Drug0.5 g methylprednisolone i.v. daily for 5 consecutive days, followed by oral prednisone for 6 months. Oral prednisone started at 40 mg/day for 4 weeks and then the dose was tapered by 5 mg/day every 2-4 weeks.
methylprednisolone(weekly scheme)
Drug0.5 g methylprednisolone i.v. weekly for 6 weeks and then the dose was tapered by 0.25 g/week over the following 6 weeks.
the overall response rate at 24 week
"Response" was defined as an improvement in at least two of the following four criteria were present, and the contralateral eye disease did not worsen: (1) the width of the eyelid was reduced by ≥2 mm; (2) The five scores of eyelid congestion, eyelid edema, conjunctival congestion, conjunctival edema and carunculae lacrimalis swelling in CAS decreased by ≥1 point; (3) The regression of exophthalmos ≥2 mm; (4) Increased eye movement ≥8° or improved diplopia ≥ grade I (continuous to interrupted, interrupted to brief, brief to none).
Changes of clinical activity score (CAS) from baseline to 24 week
changes of clinical activity score (CAS) from baseline to 24 week
changes of quality of life score (QoF-s) from baseline to 24 week
changes of quality of life score (QoF-s )
changes of exophthalmos from baseline to 24 week
changes of exophthalmos from baseline to 24 week
changes of width of the eyelid from baseline to 24 week
changes of width of the eyelid from baseline to 24 week
Changes of blood pressure from baseline to 24 week
Changes of blood pressure from baseline to 24 week
Changes of weight from baseline to 24 week
Changes of weight from baseline to 24 week
Changes of fasting blood glucose from baseline to 24 week
Changes of fasting blood glucose from baseline to 24 week
Changes of serum low density lipoprotein cholesterol
Changes of low density lipoprotein cholesterol from baseline to 24 week
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