Treatment of thyroid orbitopathy (Graves Orbitopathy) based on EUGOGO 2021 guidelines, with focus on Polish reality
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Klinika Endokrynologii i Terapii Izotopowej, CSK MON WIM w Warszawie, Polska
Klinika Diabetologii i Chorób Wewnętrznych, Uniwersyteckie Centrum Kliniczne Warszawskiego Uniwersytetu Medycznego WUM, Centralny Szpital Kliniczny, Polska
Submission date: 2022-05-18
Acceptance date: 2022-05-20
Publication date: 2022-10-12
Corresponding author
Adam Daniel Durma   

Klinika Endokrynologii i Terapii Izotopowej, CSK MON WIM w Warszawie, Szaserów 128, 04-349, Warszawa, Polska
LW 2022;100(3):146-149
The European guidelines for medical management of Graves’ orbitopathy (GO) were updated in 2021, introducing modifications to previous treatment methods. It also opened the way for new pharmacotherapeutics, which can be an alternative to standard treatment. Although some products are hardly available in Poland, the paper presents all recommended therapeutic options, focusing on the practical aspect of diagnosis and treatment. According to the current state of knowledge, the most beneficial therapeutic option in case of moderate-to-severe GO is weekly glucocorticoids (GCs) pulse therapy (4.5 g methylprednisolone per 12-week cycle) together with daily oral intake of mycophenolate. An equal option is the use of high-dose GCs (7.5 g of methylprednisolone per 12-week treatment cycle, compared to the 4.5 g previously recommended). Second-line treatment has also been updated. Treatment regimen of sight-threatening GO has not changed significantly.
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