Savino G, Balia L, Colucci D, Battendieri R, Gari M, Corsello S M, Pontecorvi A, Dickmann A
Institute of Ophthalmology, Catholic University of the Sacred Heart, Rome, Italy.
Minerva Endocrinol. 2013 Jun;38(2):173-9.
The aim of this paper was to examine the efficacy and the safety of intraorbital administration of the monoclonal anti-CD20 antibody rituximab (RTX) to treat patients affected by thyroid-associated orbitopathy (TAO) unresponsive to conventional therapy.
Five patients with active moderately-severe TAO unresponsive to systemic glucocorticoids were studied. After a complete ophthalmological examination, disease activity and severity were assessed by the clinical activity score (CAS) and the NO SPECS scoring system. Computed tomography scans were performed in all patients. Patients were treated with intraorbital injection of RTX 10 mg once a week for one month repeated once one month apart. The patients were followed every three months until 18 months.
In all patients treated with RTX, CAS was significantly reduced (p< 0,005), inactive phase of TAO was reached in four out of five patients. No patients experienced major side effects, minor side effects were reported in two patients.
Intraorbital injection of RTX is a safe and useful promising therapeutic option for active TAO.
本文旨在研究眼眶内注射单克隆抗CD20抗体利妥昔单抗（RTX）治疗对传统治疗无反应的甲状腺相关眼病（TAO）患者的疗效和安全性。
对5例对全身糖皮质激素治疗无反应的活动性中重度TAO患者进行研究。在进行全面的眼科检查后，通过临床活动评分（CAS）和NO SPECS评分系统评估疾病活动度和严重程度。所有患者均进行了计算机断层扫描。患者接受眼眶内注射RTX 10 mg，每周一次，共一个月，间隔一个月后重复一次。每三个月对患者进行随访，直至18个月。
在所有接受RTX治疗的患者中，CAS显著降低（p<0.005），五分之四的患者达到TAO非活动期。没有患者出现严重副作用，两名患者报告有轻微副作用。
眼眶内注射RTX是治疗活动性TAO的一种安全、有效且有前景的治疗选择。
