Incidence and risk factors for Graves’ orbitopathy in patients who underwent anti-inflammatory and immunosuppressive treatment during medical treatment for Graves’ disease: investigation of 1,553 cases with newly diagnosed Graves’ disease and proposal of a predictive score
Appropriate administration of anti-inflammatory and immunosuppressive treatment (AIIST) is important for patients with Graves’ orbitopathy (GO). This study aimed to clarify the incidence and risk factors for GO treated with AIIST and propose a predictive score, among newly diagnosed Graves’ disease...
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| Format: | Article |
| Language: | English |
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The Japan Endocrine Society
2023-11-01
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| Series: | Endocrine Journal |
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| Online Access: | https://www.jstage.jst.go.jp/article/endocrj/70/11/70_EJ23-0079/_html/-char/en |
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| _version_ | 1832591716146741248 |
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| author | Natsuko Watanabe Jaeduk Yoshimura Noh Ai Kozaki Ran Yoshimura Ai Yoshihara Nami Suzuki Masako Matsumoto Miho Fukushita Aya Kinoshita Azusa Aida Hideyuki Imai Shigenori Hiruma Toshu Inoue Kosuke Inoue Kiminori Sugino Koichi Ito |
| author_facet | Natsuko Watanabe Jaeduk Yoshimura Noh Ai Kozaki Ran Yoshimura Ai Yoshihara Nami Suzuki Masako Matsumoto Miho Fukushita Aya Kinoshita Azusa Aida Hideyuki Imai Shigenori Hiruma Toshu Inoue Kosuke Inoue Kiminori Sugino Koichi Ito |
| author_sort | Natsuko Watanabe |
| collection | DOAJ |
| description | Appropriate administration of anti-inflammatory and immunosuppressive treatment (AIIST) is important for patients with Graves’ orbitopathy (GO). This study aimed to clarify the incidence and risk factors for GO treated with AIIST and propose a predictive score, among newly diagnosed Graves’ disease (GD) patients in Japan. A total of 1,553 GD patients who were newly diagnosed during the year 2011 were investigated. AIIST included local and/or systemic glucocorticoid administration and retrobulbar irradiation. A multivariable Cox proportional hazards model was used to investigate the risk factors for GO underwent AIIST during medical treatment, including at diagnosis, of GD. Then, a GO score was created by summing each point assigned to risk factors based on their coefficient obtained in the Cox model. AIIST was administered to 107 patients (6.9%). The risk factors and hazard ratios for GO underwent AIIST were: age (per 10 years), 1.32 (95% confidence interval: 1.16–1.50), p < 0.0001; TSH binding inhibitory immunoglobulin (TBII) (per 10 IU/L), 1.33 (1.15–1.54), p = 0.0001; and thyroglobulin antibody (TgAb) negativity, 2.98 (1.96–4.59), p < 0.0001. The GO score, ranging from 0 to 8 points, showed moderate performance (area under the curve: 0.71, cut-off value: 5 points, sensitivity: 0.76, specificity: 0.59, positive predictive value: 0.12, negative predictive value: 0.97). AIIST was performed for patients with active manifestations of GO in 6.9% of newly diagnosed GD patients. The risk factors for GO underwent AIIST were higher age, higher TBII, and TgAb negativity. The GO score based on these factors may be useful in managing GO. |
| format | Article |
| id | doaj-art-90d4d07978994afd933f8b45f5c2c7a1 |
| institution | Kabale University |
| issn | 1348-4540 |
| language | English |
| publishDate | 2023-11-01 |
| publisher | The Japan Endocrine Society |
| record_format | Article |
| series | Endocrine Journal |
| spelling | doaj-art-90d4d07978994afd933f8b45f5c2c7a12025-01-22T06:23:18ZengThe Japan Endocrine SocietyEndocrine Journal1348-45402023-11-0170111087109610.1507/endocrj.EJ23-0079endocrjIncidence and risk factors for Graves’ orbitopathy in patients who underwent anti-inflammatory and immunosuppressive treatment during medical treatment for Graves’ disease: investigation of 1,553 cases with newly diagnosed Graves’ disease and proposal of a predictive scoreNatsuko Watanabe0Jaeduk Yoshimura Noh1Ai Kozaki2Ran Yoshimura3Ai Yoshihara4Nami Suzuki5Masako Matsumoto6Miho Fukushita7Aya Kinoshita8Azusa Aida9Hideyuki Imai10Shigenori Hiruma11Toshu Inoue12Kosuke Inoue13Kiminori Sugino14Koichi Ito15Department of Internal Medicine, Ito Hospital, Tokyo 150-8308, JapanDepartment of Internal Medicine, Ito Hospital, Tokyo 150-8308, JapanOlympia Eye Hospital, Tokyo 150-0001, JapanDepartment of Internal Medicine, Ito Hospital, Tokyo 150-8308, JapanDepartment of Internal Medicine, Ito Hospital, Tokyo 150-8308, JapanDepartment of Internal Medicine, Ito Hospital, Tokyo 150-8308, JapanDepartment of Internal Medicine, Ito Hospital, Tokyo 150-8308, JapanDepartment of Internal Medicine, Ito Hospital, Tokyo 150-8308, JapanDepartment of Internal Medicine, Ito Hospital, Tokyo 150-8308, JapanDepartment of Internal Medicine, Ito Hospital, Tokyo 150-8308, JapanDepartment of Internal Medicine, Ito Hospital, Tokyo 150-8308, JapanDepartment of Internal Medicine, Ito Hospital, Tokyo 150-8308, JapanOlympia Eye Hospital, Tokyo 150-0001, JapanDepartment of Internal Medicine, Ito Hospital, Tokyo 150-8308, JapanDepartment of Surgery, Ito Hospital, Tokyo 150-8308, JapanDepartment of Surgery, Ito Hospital, Tokyo 150-8308, JapanAppropriate administration of anti-inflammatory and immunosuppressive treatment (AIIST) is important for patients with Graves’ orbitopathy (GO). This study aimed to clarify the incidence and risk factors for GO treated with AIIST and propose a predictive score, among newly diagnosed Graves’ disease (GD) patients in Japan. A total of 1,553 GD patients who were newly diagnosed during the year 2011 were investigated. AIIST included local and/or systemic glucocorticoid administration and retrobulbar irradiation. A multivariable Cox proportional hazards model was used to investigate the risk factors for GO underwent AIIST during medical treatment, including at diagnosis, of GD. Then, a GO score was created by summing each point assigned to risk factors based on their coefficient obtained in the Cox model. AIIST was administered to 107 patients (6.9%). The risk factors and hazard ratios for GO underwent AIIST were: age (per 10 years), 1.32 (95% confidence interval: 1.16–1.50), p < 0.0001; TSH binding inhibitory immunoglobulin (TBII) (per 10 IU/L), 1.33 (1.15–1.54), p = 0.0001; and thyroglobulin antibody (TgAb) negativity, 2.98 (1.96–4.59), p < 0.0001. The GO score, ranging from 0 to 8 points, showed moderate performance (area under the curve: 0.71, cut-off value: 5 points, sensitivity: 0.76, specificity: 0.59, positive predictive value: 0.12, negative predictive value: 0.97). AIIST was performed for patients with active manifestations of GO in 6.9% of newly diagnosed GD patients. The risk factors for GO underwent AIIST were higher age, higher TBII, and TgAb negativity. The GO score based on these factors may be useful in managing GO.https://www.jstage.jst.go.jp/article/endocrj/70/11/70_EJ23-0079/_html/-char/engraves’ orbitopathygraves’ diseasethyroid eye diseasetsh binding inhibitory immunoglobulinthyroglobulin antibody |
| spellingShingle | Natsuko Watanabe Jaeduk Yoshimura Noh Ai Kozaki Ran Yoshimura Ai Yoshihara Nami Suzuki Masako Matsumoto Miho Fukushita Aya Kinoshita Azusa Aida Hideyuki Imai Shigenori Hiruma Toshu Inoue Kosuke Inoue Kiminori Sugino Koichi Ito Incidence and risk factors for Graves’ orbitopathy in patients who underwent anti-inflammatory and immunosuppressive treatment during medical treatment for Graves’ disease: investigation of 1,553 cases with newly diagnosed Graves’ disease and proposal of a predictive score Endocrine Journal graves’ orbitopathy graves’ disease thyroid eye disease tsh binding inhibitory immunoglobulin thyroglobulin antibody |
| title | Incidence and risk factors for Graves’ orbitopathy in patients who underwent anti-inflammatory and immunosuppressive treatment during medical treatment for Graves’ disease: investigation of 1,553 cases with newly diagnosed Graves’ disease and proposal of a predictive score |
| title_full | Incidence and risk factors for Graves’ orbitopathy in patients who underwent anti-inflammatory and immunosuppressive treatment during medical treatment for Graves’ disease: investigation of 1,553 cases with newly diagnosed Graves’ disease and proposal of a predictive score |
| title_fullStr | Incidence and risk factors for Graves’ orbitopathy in patients who underwent anti-inflammatory and immunosuppressive treatment during medical treatment for Graves’ disease: investigation of 1,553 cases with newly diagnosed Graves’ disease and proposal of a predictive score |
| title_full_unstemmed | Incidence and risk factors for Graves’ orbitopathy in patients who underwent anti-inflammatory and immunosuppressive treatment during medical treatment for Graves’ disease: investigation of 1,553 cases with newly diagnosed Graves’ disease and proposal of a predictive score |
| title_short | Incidence and risk factors for Graves’ orbitopathy in patients who underwent anti-inflammatory and immunosuppressive treatment during medical treatment for Graves’ disease: investigation of 1,553 cases with newly diagnosed Graves’ disease and proposal of a predictive score |
| title_sort | incidence and risk factors for graves orbitopathy in patients who underwent anti inflammatory and immunosuppressive treatment during medical treatment for graves disease investigation of 1 553 cases with newly diagnosed graves disease and proposal of a predictive score |
| topic | graves’ orbitopathy graves’ disease thyroid eye disease tsh binding inhibitory immunoglobulin thyroglobulin antibody |
| url | https://www.jstage.jst.go.jp/article/endocrj/70/11/70_EJ23-0079/_html/-char/en |
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