Immunotherapy for Graves' ophthalmopathy

Research output: Contribution to journalArticle

Abstract

PURPOSE OF REVIEW: In recent years, immunosuppressive therapy, as an alternative to corticosteroids, has been proposed as novel agents which target the various antigens involved in the pathogenesis of Graves' ophthalmopathy. Although the lack of randomized and controlled studies suggests caution in generalizing results, some data show interesting results.

RECENT FINDINGS: Potential targets for immune therapy in Graves' ophthalmopathy are the antigens expressed on the target organ of inflammation, namely the receptor and the insulin growth factor -1 receptor on fibroblasts, inflammatory cytokines, and B and T cells. The most promising results are observed with small thyroid stimulating hormone receptor molecules interacting with the receptor on thyrocytes and fibroblasts and with the anti-IGF-1 receptor antibody teprotumumab. A recent open study with tocilizumab, an anti-soluble interleukin-6 receptor, has shown inactivation of Graves' ophthalmopathy. Consistent reports on the efficacy of rituximab will have to be confirmed by randomized controlled trials, which are now in progress.

SUMMARY: Current clinical practice for Graves' ophthalmopathy will greatly benefit from the availability of immunosuppressors that act as disease-modifying drugs, as compared to steroids, the current standard treatment for Graves' ophthalmopathy. Rituximab seems to be a good candidate, as preliminary results from ongoing randomized trials suggest good efficacy with a relative well tolerated profile.

Original languageEnglish
Pages (from-to)409-414
Number of pages6
JournalCurrent opinion in endocrinology, diabetes, and obesity
Volume21
Issue number5
DOIs
Publication statusPublished - Oct 1 2014

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Graves Ophthalmopathy
Immunotherapy
R-1507 monoclonal antibody
Receptor, Fibroblast Growth Factor, Type 1
Interleukin-6 Receptors
Antigens
Thyrotropin Receptors
IGF Type 1 Receptor
Insulin Receptor
Immunosuppressive Agents
Complementary Therapies
Adrenal Cortex Hormones
B-Lymphocytes
Randomized Controlled Trials
Fibroblasts
Steroids
Cytokines
Inflammation
T-Lymphocytes
Antibodies

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Immunotherapy for Graves' ophthalmopathy. / Salvi, Mario.

In: Current opinion in endocrinology, diabetes, and obesity, Vol. 21, No. 5, 01.10.2014, p. 409-414.

Research output: Contribution to journalArticle

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