title: Methotrexate for the treatment of thyroid eye disease.
abstract: Background/Aim. To evaluate the efficacy of methotrexate for the treatment of thyroid eye disease (TED). Methods. 36 consecutive patients with active TED, previously treated with corticosteroids but stopped due to the occurrence of side effects, were commenced on methotrexate therapy. Two different weekly doses were administered depending on the weight of the patient (7.5 mg or 10 mg). Clinical activity score (7-CAS), visual acuity (VA), ocular motility, exophthalmos, and eyelid position were retrospectively evaluated at 3, 6, and 12 months and compared with baseline data. Results. There was a statistically significant improvement in 7-CAS at 3, 6, and 12 months after treatment (P < 0.0001). There was no significant change in visual acuity. Ocular motility disturbances improved at 6 and 12 months (P < 0.001). There was no significant change in exophthalmos (mean 24 mm, SD 3 mm) or eyelid position (marginal reflex distance mean 6 mm, SD 1.5 mm) during the follow-up period. No side effects were registered. Conclusions. Methotrexate therapy is effective in reducing CAS and ocular motility disturbances. No significant improvement in proptosis or eyelid retraction should be expected from this treatment. Eventually, it might be considered a suitable alternative treatment in TED for patients who cannot tolerate steroids.
authors.affiliation: Department of Neuroscience, Odontostomatological and Reproductive Sciences, University "Federico II" of Naples, Via Pansini No. 5, 80131 Naples, Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Strianese
authors.affiliation: Department of Neuroscience, Odontostomatological and Reproductive Sciences, University "Federico II" of Naples, Via Pansini No. 5, 80131 Naples, Italy.
authors.forename: Adriana
authors.initials: A
authors.lastname: Iuliano
authors.affiliation: Department of Neuroscience, Odontostomatological and Reproductive Sciences, University "Federico II" of Naples, Via Pansini No. 5, 80131 Naples, Italy.
authors.forename: Mariantonia
authors.initials: M
authors.lastname: Ferrara
authors.affiliation: Department of Neuroscience, Odontostomatological and Reproductive Sciences, University "Federico II" of Naples, Via Pansini No. 5, 80131 Naples, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Comune
authors.affiliation: Department of Neuroscience, Odontostomatological and Reproductive Sciences, University "Federico II" of Naples, Via Pansini No. 5, 80131 Naples, Italy.
authors.forename: Immacolata
authors.initials: I
authors.lastname: Baronissi
authors.affiliation: Department of Neuroscience, Odontostomatological and Reproductive Sciences, University "Federico II" of Naples, Via Pansini No. 5, 80131 Naples, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Napolitano
authors.affiliation: Department of Neuroscience, Odontostomatological and Reproductive Sciences, University "Federico II" of Naples, Via Pansini No. 5, 80131 Naples, Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: D'Alessandro
authors.affiliation: Department of Neuroscience, Odontostomatological and Reproductive Sciences, University "Federico II" of Naples, Via Pansini No. 5, 80131 Naples, Italy.
authors.forename: Piergiacomo
authors.initials: P
authors.lastname: Grassi
authors.affiliation: Department of Neuroscience, Odontostomatological and Reproductive Sciences, University "Federico II" of Naples, Via Pansini No. 5, 80131 Naples, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Bonavolontà
authors.affiliation: Department of Neuroscience, Odontostomatological and Reproductive Sciences, University "Federico II" of Naples, Via Pansini No. 5, 80131 Naples, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Bonavolontà
authors.affiliation: Department of Endocrinology, Second University of Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Sinisi
authors.affiliation: Department of Neuroscience, Odontostomatological and Reproductive Sciences, University "Federico II" of Naples, Via Pansini No. 5, 80131 Naples, Italy.
authors.forename: Fausto
authors.initials: F
authors.lastname: Tranfa