The overall objective of the study is to evaluate the safety and efficacy of rabbit antithymocyte globulin in the treatment of Graves orbitopathy (GO) after ineffective treatment with moderate-to-high doses of glucocorticoids.
This is a prospective interventional, single-center study examining the safety and efficacy of rabbit antithymocyte globulin (rATG) in adult patients with active moderate-to-severe GO after ineffective treatment with moderate-to-high doses of glucocorticoids. All enrolled participants will receive 0.8 - 1.0 mg/kg of rATG (cumulative dose of 150-200 mg given intravenously in two or three divided doses, 24 hours apart) after premedication with methylprednisolone i.v. (in total dose of 375 mg), 1 mg of antihistaminic agent clemastine and 1000 mg paracetamol i.v. In order to assess efficacy and safety of the treatment, patients will be evaluated at baseline and at 6, 12, 24 and 48 weeks. Baseline and subsequent evaluation will involve medical history, physical examination, including detailed eye examination, laboratory assessment (thyroid-stimulating hormone \[TSH\], flow cytometry, TSH-receptor antibodies, CBC) and orbital magnetic resonance imaging (MRI).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
20
0.8 - 1.0 mg/kg of rATG (cumulative dose of 150-200 mg given intravenously in two or three divided doses, 24 hours apart) after premedication with methylprednisolone i.v. (in total dose of 375 mg), 1 mg of antihistaminic agent clemastine and 1000 mg paracetamol i.v.
Department of Internal Medicine and Oncological Chemotherapy, Medical Faculty in Katowice, Medical University of Silesia
Katowice, Silesian Voivodeship, Poland
RECRUITING≥2 point change in Clinical Activity Score from baseline
Time frame: Week 6, 12, 24, 48
change in proptosis
Time frame: 48 weeks
a diplopia response
Time frame: 48 weeks
change of distant best-corrected visual acuity
Time frame: Week 6, 12, 24, 48
change of mean retinal sensitivity
Time frame: Week 6, 12, 24, 48
changes in CD4/CD8 ratio
Time frame: Week 6, 12, 24, 48
changes in TSH-receptor antibodies level
Time frame: Week 6, 12, 24, 48
increase in 1 degree amplitude in Pattern visual evoked potential (VEP) by 1 µV
Time frame: Week 6, 12, 24, 48
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