Nielsen Claus Henrik, El Fassi Daniel, Hegedüs Laszlo
Rigshospitalet, Vaevstypelaboratoriet Afsnit 7631, København Ø.
Ugeskr Laeger. 2008 Jun 9;170(24):2131-4.
Graves' disease (GD) is caused by autoantibodies to the thyrotropin receptor (TRAb). In a controlled study using the B-lymphocyte depleting agent rituximab (RTX), an RTX-specific effect was found on long-term remission following methimazole (MMI) therapy. However, benefits were limited to patients with low baseline TRAb levels, and the decrease in TRAb levels observed after treatment with RTX in combination with MMI was no greater than that observed after treatment with MMI alone. Considering its price and adverse effect profile, RTX therapy does not seem to be a relevant treatment option in uncomplicated GD. The potential use of other immunomodulatory agents in GD is discussed.
格雷夫斯病（GD）由针对促甲状腺激素受体（TRAb）的自身抗体引起。在一项使用B淋巴细胞清除剂利妥昔单抗（RTX）的对照研究中，发现RTX对甲巯咪唑（MMI）治疗后的长期缓解有特异性作用。然而，益处仅限于基线TRAb水平较低的患者，并且RTX联合MMI治疗后观察到的TRAb水平下降并不比单独使用MMI治疗后观察到的更大。考虑到其价格和不良反应，RTX疗法似乎不是单纯性GD的合适治疗选择。文中讨论了其他免疫调节剂在GD中的潜在用途。
