Multi-center study on the characteristics and treatment strategies of patients with Graves' orbitopathy: the first European Group on Graves' Orbitopathy experience.
To improve management of patients with Graves' orbitopathy, a multi-center collaborative approach is necessary in order to have large enough sample sizes for meaningful randomized clinical trials. This is hampered by a lack of consensus on how to investigate the eye condition. The European Group on Graves' Orbitopathy aims to overcome this and has designed a preliminary case record form (CRF) to assess Graves' orbitopathy patients. This form was used in this first multi-center study.


OBJECTIVE
To investigate patient characteristics and treatment strategies in 152 new consecutively referred patients with thyroid eye disease seen in nine large European referral centers.


METHODS
Newly referred patients with Graves' orbitopathy were included who were seen between September and December 2000. Demographic data and a complete ophthalmological assessment were recorded.


RESULTS
One-hundred and fifty-two patients (77% females) were included. Diabetes was present in 9%, and glaucoma or cataract in 14% of patients. Forty percent were current smokers, 9% also had dermopathy, and only 33% reported a positive family history of thyroid disease. Mild eye disease was seen in 40%, moderately severe eye disease was seen in 33% and severe eye disease was seen in 28% of patients. Soft tissue involvement was the most frequent abnormality (seen in 75%), proptosis > or =21 mm was found in 63%, eye motility dysfunction in 49%, keratopathy in 16% and optic nerve involvement was found in 21% of patients. According to the clinical impression, 60% had active eye disease. Immunosuppressive treatment was planned more frequently in active patients (57/86; 66%) than in inactive patients (5/57, 9%; Chi-square 46.16; P<0.02). There were no important differences among the eight centers regarding the severity and the activity of their patients.


CONCLUSIONS
In view of the large number of patients recruited in only 4 months, multi-center studies in the eight EUGOGO centers appear to be feasible.
Prummel
Mark F
MF
Department of Endocrinology and Metabolism, F5-171 Academic Medical Center, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands. m.f.prummel@amc.uva.nl
Bakker
Annemieke
A
Wiersinga
Wilmar M
WM
Baldeschi
Lelio
L
Mourits
Maarten P
MP
Kendall-Taylor
Pat
P
Perros
Petros
P
Neoh
Chris
C
Dickinson
A Jane
AJ
Lazarus
John H
JH
Lane
Carol M
CM
Heufelder
Armin E
AE
Kahaly
George J
GJ
Pitz
Suzanne
S
Orgiazzi
Jacques
J
Hullo
Alain
A
Pinchera
Aldo
A
Marcocci
Claudio
C
Sartini
Maria S
MS
Rocchi
Roberto
R
Nardi
Marco
M
Krassas
Gerry E
GE
Halkias
A
A
D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006111:Graves Disease / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index
D007166:Immunosuppressive Agents