A5009813631- Ophthalmology and Eye Disorders
- Thyroid Disorders and Treatments
- Pituitary Gland Disorders and Treatments
- Glaucoma and retinal disorders
- Growth Hormone and Insulin-like Growth Factors
- Diabetes and associated disorders
- Erythrocyte Function and Pathophysiology
- Cerebral Venous Sinus Thrombosis
- Thyroid Cancer Diagnosis and Treatment
- Autoimmune Neurological Disorders and Treatments
- Immunodeficiency and Autoimmune Disorders
- Child Abuse and Related Trauma
- Monoclonal and Polyclonal Antibodies Research
- Advanced Differential Geometry Research
- Medical and Biological Sciences
- COVID-19 Clinical Research Studies
- Neonatal Health and Biochemistry
- T-cell and B-cell Immunology
- Ocular Surface and Contact Lens
- Biomarkers in Disease Mechanisms
- Adrenal Hormones and Disorders
- Vestibular and auditory disorders
- Blood groups and transfusion
- Skin Diseases and Diabetes
- Sympathectomy and Hyperhidrosis Treatments
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
2015-2024
University of Milan
2014-2024
University of Padua
2024
Istituto Nazionale Genetica Molecolare
2024
University of Parma
1992-2016
McGill University
1987-2015
Montreal General Hospital
1987-2015
Ospedale Maggiore
2009-2015
I.R.C.C.S. Oasi Maria SS
2015
Endocrinology Research Center
2010
Graves' orbitopathy (GO) is the main extrathyroidal manifestation of disease, though severe forms are rare. Management GO often suboptimal, largely because available treatments do not target pathogenic mechanisms disease. Treatment should rely on a thorough assessment activity and severity its impact patient's quality life. Local measures (artificial tears, ointments dark glasses) control risk factors for progression (smoking thyroid dysfunction) recommended all patients. In mild GO,...
Summary of consensus a. All patients with GO should (Fig. 1):Be referred to specialist centers;Be encouraged quit smoking;Receive prompt treatment in order restore andmaintain euthyroidism.b. Patients sight-threatening be treatedwith i.v. GCs as the first-line treatment; if responseis poor after 1–2 weeks, they submitted tourgent surgical decompression.c. The choice for moderate-to-severe isi.v. (with or without OR) orbitopathy isactive;surgery(orbitaldecompression,squintsurgery,and/or eyelid...
Thyroid-associated ophthalmopathy, a condition commonly associated with Graves' disease, remains inadequately treated. Current medical therapies, which primarily consist of glucocorticoids, have limited efficacy and present safety concerns. Inhibition the insulin-like growth factor I receptor (IGF-IR) is new therapeutic strategy to attenuate underlying autoimmune pathogenesis ophthalmopathy.
Thyroid eye disease is a debilitating, disfiguring, and potentially blinding periocular condition for which no Food Drug Administration-approved medical therapy available. Strong evidence has implicated the insulin-like growth factor I receptor (IGF-IR) in pathogenesis of this disease.In randomized, double-masked, placebo-controlled, phase 3 multicenter trial, we assigned patients with active thyroid 1:1 ratio to receive intravenous infusions IGF-IR inhibitor teprotumumab (10 mg per kilogram...
Preliminary studies have shown that rituximab (RTX) is effective in the treatment of active Graves' orbitopathy (GO).We conducted a double-blind, randomized trial (European Clinical Trials Database [EudraCT] 2007-003910-33) to compare RTX with iv methylprednisolone (ivMP) patients moderate severe GO. Thirty-two were receive either ivMP (7.5 g) or (2000 500 mg). The primary end point was decrease clinical activity score 2 points less than 3 at week 24. Changes proptosis, lid fissure, diplopia...
Optimal doses of iv glucocorticoids for Graves' orbitopathy (GO) are undefined. We carried out a multicenter, randomized, double-blind trial to determine efficacy and safety three methylprednisolone in 159 patients with moderate severe active GO. Patients were randomized receive cumulative dose 2.25, 4.98, or 7.47 g 12 weekly infusions. Efficacy was evaluated objectively at wk by blinded ophthalmologists subjectively (using GO specific quality life questionnaire). Adverse events recorded...
To evaluate teprotumumab safety/efficacy in patients with thyroid eye disease (TED) who were nonresponsive or experienced a flare.The Treatment of Graves' Orbitopathy to Reduce Proptosis Teprotumumab Infusions an Open-Label Clinical Extension Study (OPTIC-X) is treatment and re-treatment trial following the placebo-controlled Phase 3 (Thyroid Eye Disease) Randomized, Placebo-Controlled, (OPTIC) trial.Patients previously received placebo (n = 37) 14) OPTIC.OPTIC nonresponders those flared...
Thyroid eye disease (TED) remains challenging for clinicians to evaluate and manage. Novel therapies have recently emerged, their specific roles are still being determined. Most patients with TED develop manifestations while treated hyperthyroidism under the care of endocrinologists. Endocrinologists, therefore, a key role in diagnosis, initial management, selection who require referral specialist care. Given that need guidance endocrinologists charged meeting needs transcends national...
Introduction : Hyperthyroid Graves’ disease (GD) is a B-cell-mediated condition caused by TSH receptor antibodies (TRAb), which decline when GD remits. Anti-CD20 monoclonal antibody rituximab (RTX) induces transient B-cell depletion that may potentially modify the active inflammatory phase of thyroid-associated ophthalmopathy (TAO). Methods Nine patients with GD, (seven TAO, two mild lid signs) were studied. The trial was only approved as an open pilot study; thus we compared effect RTX...
<h3>Aim:</h3> To compare the outcome of various surgical approaches orbital decompression in patients with Graves' orbitopathy (GO) receiving surgery for disfiguring proptosis. <h3>Method:</h3> Data forms and questionnaires from consecutive, euthyroid inactive GO who had undergone proptosis 11 European centres were analysed. <h3>Results:</h3> Eighteen different (combinations of) used, swinging eyelid approach being most popular followed by coronal transconjunctival approaches. The average...
Graves' orbitopathy (GO) is an autoimmune condition, which associated with poor clinical outcomes including impaired quality of life and socio-economic status. Current evidence suggests that the incidence GO in Europe may be declining, however data on prevalence this disease are sparse. Several variants exist, euthyroid GO, recently listed as a rare (ORPHA466682). The objective was to estimate its Europe, based available literature, consider whether they potentially qualify rare. Recent...
While pulsed intravenous methylprednisolone (iv-MP) has been shown to be effective and well tolerated in moderate severe Graves' orbitopathy (GO), limited data are available on dysthyroid optic neuropathy (DON). The objective of this retrospective study was investigate the efficacy iv-MP treatment DON seek parameters predictive response.Twenty-four patients (40 eyes) treated with from 2007 2012 were included study. Concurrent neurological or ophthalmologic diseases signs corneal exposure...
<h3>Background/aims</h3> The epidemiology of Graves’ orbitopathy (GO) may be changing. aim the study was to identify trends in presentation GO tertiary centres and initial management over time. <h3>Methods</h3> Prospective observational European Group On Orbitopathy (EUGOGO) centres. All new referrals with a diagnosis 4-month period 2012 were included. Clinical demographic characteristics, referral timelines decisions about recorded. data compared similar EUGOGO survey performed 2000....
Thyroid eye disease (TED) remains challenging for clinicians to evaluate and manage. Novel therapies have recently emerged, their specific roles are still being determined. Most patients with TED develop manifestations while treated hyperthyroidism under the care of endocrinologists. Endocrinologists, therefore, a key role in diagnosis, initial management, selection who require referral specialist care. Given that need guidance endocrinologists charged meeting needs transcends national...
Abstract Context Gut bacteria can influence host immune responses but little is known about their role in tolerance-loss mechanisms Graves disease (GD; hyperthyroidism caused by autoantibodies, TRAb, to the thyrotropin receptor, TSHR) and its progression orbitopathy (GO). Objective This work aimed compare fecal microbiota GD patients, with GO of varying severity, healthy controls (HCs). Methods Patients were recruited from 4 European countries (105 41 HCs) for an observational study...
One patient with Graves' hyperthyroidism and ophthalmopathy in its active phase unresponsive to steroid, was treated the anti-CD20 monoclonal antibody, rituximab (RTX), as part of an open study. The effect RTX thyroid orbital tissues studied. responded therapy by ameliorating eye signs a decrease clinical activity score from 5 2 3 months, while had peripheral B-cell depletion. Hyperthyroidism did not improve during 6 months depletion serum TSH-receptor antibodies (TRAb) levels significantly...
In the present study we have measured concentrations of interleukin-6 (IL-6), soluble IL-6 receptor (sIL-6R), tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta) and IL-1 antagonist (IL-1Ra) in serum patients with Graves' disease (GD). By multivariate analysis, evaluated effect antithyroid treatment, thyroid function, presence or absence active thyroid-associated ophthalmopathy (TAO), patient's smoking habits relation to circulating anti-thyrotropin (TSH) (TRAb)...
Increased serum interleukin-6 (IL-6) concentrations have been reported in patients with thyroid destructive processes. In the present study we measured IL-6 and soluble receptor (sIL-6R) of normal subjects Graves' disease using a high sensitivity sandwich enzyme-linked immunoassay. We found increased sIL-6R (69.3 fmol/L, 964 pmol/L, respectively) 49 hyperthyroid (GD) compared to those controls [55.8 fmol/L (P = 0.019) 772 pmol/L 0.007), respectively]. 31 newly diagnosed GD patients, during...
A 64 kDa protein has been identified in the membrane fraction of human eye muscle, orbital connective tissue and thyroid, by testing sera patients with thyroid‐associated ophthalmopathy SDS‐polyacrylamide gel electrophoresis Western blotting. Antibodies to this antigen seem characteristic early stage ophthalmopathy. In thyroid newly recognized seems different from previously known antigens. antibody reactive a muscle could explain very frequent association autoimmune disease.
To study the clinical involvement of ocular surface and in vivo morphology corneal cells nerves, patients affected by active inactive Graves' orbitopathy (GO).The included 26 consecutive GO 20 age- sex-matched healthy control subjects. was diagnosed on basis criteria European Group Orbitopathy, disease activity evaluated Clinical Activity Score (CAS). Each participant underwent a full eye examination, including an evaluation symptoms (Ocular Surface Disease Index score), tear break-up time,...