Colchicine in the treatment of the inflammatory phase of Graves' ophthalmopathy: a prospective and randomized trial with prednisone.
OBJECTIVE
To investigate if colchicine is valuable in the treatment of Graves' ophthalmopathy (GO), we compared its effect with prednisone in 22 patients during the inflammatory phase of GO.


METHODS
All patients, similar in age, sex and smoking habits, were euthyroid for at least 3 months and randomly divided into two groups, one treated with colchicine (1.5 mg/day) and the other treated with prednisone (0.75 mg/kg/day). They were monitored with ophthalmologic assessment (clinical activity score-CAS) and magnetic resonance imaging, using a signal intensity ratio (SIR) of the recti muscles in comparison to the cerebral substantia alba.


RESULTS
Amelioration of CAS was seen in 68% of the orbits in both groups. SIR also had a significant reduction after treatment: the initial median of 1.14 in G1 and 1.27 in G2, evolved, after treatment, to 1.07 in G1 and 0.69 in G2. The variation between both groups after treatment was not significant (p=0.22). None of the patients treated with colchicine had side effects; on the other hand, side effects in G2 were weight gain, edema, gastric complaints, hirsutism, weakness, depression, and alterations in blood pressure.


CONCLUSIONS
Colchicine had a beneficial effect on the inflammatory phase of GO without the side effects of prednisone.
Stamato
Francisco José da Cunha
FJ
Division of Endocrinology, Department of Medicine, Universidade Federal de São Paulo, Alameda Jaú, 310/91 São Paulo, SP, Brazil CEP 01420-000. franstamato@hotmail.com
Maciel
Rui Monterio de Barros
RM
Manso
Paulo Gois
PG
Wolosker
Angela Maria Borri
AM
Paiva
Elias Rodrigues de
ER
Lopes
Antonio Carlos
AC
Furlanetto
Reinaldo Perrone
RP
D000328:Adult; D000368:Aged; D003078:Colchicine / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use*; D049970:Graves Ophthalmopathy / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000000981:diagnostic imaging; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome
D005938:Glucocorticoids; D003078:Colchicine; D011241:Prednisone