Predictive score for the development or progression of Graves' orbitopathy in patients with newly diagnosed Graves' hyperthyroidism

EUGOGO (European Group on Graves’ Orbitopathy)

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

OBJECTIVE: To construct a predictive score for the development or progression of Graves' orbitopathy (GO) in Graves' hyperthyroidism (GH).

DESIGN: Prospective observational study in patients with newly diagnosed GH, treated with antithyroid drugs (ATD) for 18 months at ten participating centers from EUGOGO in 8 European countries.

METHODS: 348 patients were included with untreated GH but without obvious GO. Mixed effects logistic regression was used to determine the best predictors. A predictive score (called PREDIGO) was constructed.

RESULTS: GO occurred in 15% (mild in 13% and moderate to severe in 2%), predominantly at 6-12 months after start of ATD. Independent baseline determinants for the development of GO were clinical activity score (assigned 5 points if score > 0), TSH-binding inhibitory immunoglobulins (2 points if TBII 2-10 U/L, 5 points if TBII > 10 U/L), duration of hyperthyroid symptoms (1 point if 1-4 months, 3 points if >4 months) and smoking (2 points if current smoker). Based on the odds ratio of each of these four determinants, a quantitative predictive score (called PREDIGO) was constructed ranging from 0 to 15 with higher scores denoting higher risk; positive and negative predictive values were 0.28 (95% CI 0.20-0.37) and 0.91 (95% CI 0.87-0.94) respectively.

CONCLUSIONS: In patients without GO at diagnosis, 15% will develop GO (13% mild, 2% moderate to severe) during subsequent treatment with ATD for 18 months. A predictive score called PREDIGO composed of four baseline determinants was better in predicting those patients who will not develop obvious GO than who will.

Original languageEnglish
Pages (from-to)635-643
Number of pages9
JournalEuropean Journal of Endocrinology
Volume178
Issue number6
DOIs
Publication statusPublished - Jun 1 2018

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Hyperthyroidism
Antithyroid Agents
Observational Studies
Logistic Models
Smoking
Odds Ratio
Prospective Studies
Therapeutics

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Predictive score for the development or progression of Graves' orbitopathy in patients with newly diagnosed Graves' hyperthyroidism. / EUGOGO (European Group on Graves’ Orbitopathy).

In: European Journal of Endocrinology, Vol. 178, No. 6, 01.06.2018, p. 635-643.

Research output: Contribution to journalArticle

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title = "Predictive score for the development or progression of Graves' orbitopathy in patients with newly diagnosed Graves' hyperthyroidism",
abstract = "OBJECTIVE: To construct a predictive score for the development or progression of Graves' orbitopathy (GO) in Graves' hyperthyroidism (GH).DESIGN: Prospective observational study in patients with newly diagnosed GH, treated with antithyroid drugs (ATD) for 18 months at ten participating centers from EUGOGO in 8 European countries.METHODS: 348 patients were included with untreated GH but without obvious GO. Mixed effects logistic regression was used to determine the best predictors. A predictive score (called PREDIGO) was constructed.RESULTS: GO occurred in 15{\%} (mild in 13{\%} and moderate to severe in 2{\%}), predominantly at 6-12 months after start of ATD. Independent baseline determinants for the development of GO were clinical activity score (assigned 5 points if score > 0), TSH-binding inhibitory immunoglobulins (2 points if TBII 2-10 U/L, 5 points if TBII > 10 U/L), duration of hyperthyroid symptoms (1 point if 1-4 months, 3 points if >4 months) and smoking (2 points if current smoker). Based on the odds ratio of each of these four determinants, a quantitative predictive score (called PREDIGO) was constructed ranging from 0 to 15 with higher scores denoting higher risk; positive and negative predictive values were 0.28 (95{\%} CI 0.20-0.37) and 0.91 (95{\%} CI 0.87-0.94) respectively.CONCLUSIONS: In patients without GO at diagnosis, 15{\%} will develop GO (13{\%} mild, 2{\%} moderate to severe) during subsequent treatment with ATD for 18 months. A predictive score called PREDIGO composed of four baseline determinants was better in predicting those patients who will not develop obvious GO than who will.",
author = "{EUGOGO (European Group on Graves’ Orbitopathy)} and Wilmar Wiersinga and Miloš Žarković and Luigi Bartalena and Simone Donati and Petros Perros and Onyebuchi Okosieme and Daniel Morris and Nicole Fichter and Jurg Lareida and {von Arx}, Georg and Chantal Daumerie and Burlacu, {Maria Christina} and George Kahaly and Susanne Pitz and Biljana Beleslin and Jasmina Ćirić and Goksun Ayvaz and Onur Konuk and T{\"o}r{\"u}ner, {F{\"u}sun Balos} and Mario Salvi and Danila Covelli and Nicola Curro and Laszlo Heged{\"u}s and Thomas Brix",
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T1 - Predictive score for the development or progression of Graves' orbitopathy in patients with newly diagnosed Graves' hyperthyroidism

AU - EUGOGO (European Group on Graves’ Orbitopathy)

AU - Wiersinga, Wilmar

AU - Žarković, Miloš

AU - Bartalena, Luigi

AU - Donati, Simone

AU - Perros, Petros

AU - Okosieme, Onyebuchi

AU - Morris, Daniel

AU - Fichter, Nicole

AU - Lareida, Jurg

AU - von Arx, Georg

AU - Daumerie, Chantal

AU - Burlacu, Maria Christina

AU - Kahaly, George

AU - Pitz, Susanne

AU - Beleslin, Biljana

AU - Ćirić, Jasmina

AU - Ayvaz, Goksun

AU - Konuk, Onur

AU - Törüner, Füsun Balos

AU - Salvi, Mario

AU - Covelli, Danila

AU - Curro, Nicola

AU - Hegedüs, Laszlo

AU - Brix, Thomas

PY - 2018/6/1

Y1 - 2018/6/1

N2 - OBJECTIVE: To construct a predictive score for the development or progression of Graves' orbitopathy (GO) in Graves' hyperthyroidism (GH).DESIGN: Prospective observational study in patients with newly diagnosed GH, treated with antithyroid drugs (ATD) for 18 months at ten participating centers from EUGOGO in 8 European countries.METHODS: 348 patients were included with untreated GH but without obvious GO. Mixed effects logistic regression was used to determine the best predictors. A predictive score (called PREDIGO) was constructed.RESULTS: GO occurred in 15% (mild in 13% and moderate to severe in 2%), predominantly at 6-12 months after start of ATD. Independent baseline determinants for the development of GO were clinical activity score (assigned 5 points if score > 0), TSH-binding inhibitory immunoglobulins (2 points if TBII 2-10 U/L, 5 points if TBII > 10 U/L), duration of hyperthyroid symptoms (1 point if 1-4 months, 3 points if >4 months) and smoking (2 points if current smoker). Based on the odds ratio of each of these four determinants, a quantitative predictive score (called PREDIGO) was constructed ranging from 0 to 15 with higher scores denoting higher risk; positive and negative predictive values were 0.28 (95% CI 0.20-0.37) and 0.91 (95% CI 0.87-0.94) respectively.CONCLUSIONS: In patients without GO at diagnosis, 15% will develop GO (13% mild, 2% moderate to severe) during subsequent treatment with ATD for 18 months. A predictive score called PREDIGO composed of four baseline determinants was better in predicting those patients who will not develop obvious GO than who will.

AB - OBJECTIVE: To construct a predictive score for the development or progression of Graves' orbitopathy (GO) in Graves' hyperthyroidism (GH).DESIGN: Prospective observational study in patients with newly diagnosed GH, treated with antithyroid drugs (ATD) for 18 months at ten participating centers from EUGOGO in 8 European countries.METHODS: 348 patients were included with untreated GH but without obvious GO. Mixed effects logistic regression was used to determine the best predictors. A predictive score (called PREDIGO) was constructed.RESULTS: GO occurred in 15% (mild in 13% and moderate to severe in 2%), predominantly at 6-12 months after start of ATD. Independent baseline determinants for the development of GO were clinical activity score (assigned 5 points if score > 0), TSH-binding inhibitory immunoglobulins (2 points if TBII 2-10 U/L, 5 points if TBII > 10 U/L), duration of hyperthyroid symptoms (1 point if 1-4 months, 3 points if >4 months) and smoking (2 points if current smoker). Based on the odds ratio of each of these four determinants, a quantitative predictive score (called PREDIGO) was constructed ranging from 0 to 15 with higher scores denoting higher risk; positive and negative predictive values were 0.28 (95% CI 0.20-0.37) and 0.91 (95% CI 0.87-0.94) respectively.CONCLUSIONS: In patients without GO at diagnosis, 15% will develop GO (13% mild, 2% moderate to severe) during subsequent treatment with ATD for 18 months. A predictive score called PREDIGO composed of four baseline determinants was better in predicting those patients who will not develop obvious GO than who will.

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U2 - 10.1530/EJE-18-0039

DO - 10.1530/EJE-18-0039

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JO - European Journal of Endocrinology

JF - European Journal of Endocrinology

SN - 0804-4643

IS - 6

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