 |
 |
|
|
|  PubMed
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
15 October 1998 | Volume 129 Issue 8 | Pages 632-635
Background: It is unclear whether smoking affects the course of Graves ophthalmopathy and therapeutic outcomes.
Objective: To observe smoking behavior in a randomized study of the effect of radioiodine therapy on ophthalmopathy and in a case series of patients with Graves ophthalmopathy receiving orbital radiation therapy and glucocorticoids.
Design: Randomized, single-blind study of smoking and mild ophthalmopathy after radioiodine therapy (study 1) and a retrospective cohort study of the association between smoking and response of severe ophthalmopathy to treatment (study 2).
Setting: University medical center.
Patients: 300 patients with mild ophthalmopathy (study 1) and 150 patients with severe ophthalmopathy (study 2).
Intervention: In study 1, patients received radioiodine alone or radioiodine and a 3-month course of oral prednisone (initial dosage, 0.4 to 0.5 mg/kg of body weight per day). In study 2, patients received high-dose oral prednisone for 6 months (initial dosage, 80 to 100 mg/d) and underwent orbital radiation therapy by linear accelerator (cumulative dose, 20 Gy per eye over 2 weeks).
Measurements: Degree of ophthalmopathy was assessed by overall evaluation (inflammatory changes, proptosis, extraocular muscle dysfunction, corneal involvement, and optic neuropathy).
Results: In study 1, ophthalmopathy progressed in 4 of 68 nonsmokers (5.9% [95% CI, 3% to 9%]) and 19 of 82 smokers (23.2% [CI, 13% to 33%]) who received radioiodine alone (P = 0.007). Ophthalmopathy was alleviated in 37 of 58 nonsmokers (63.8% [CI, 51% to 78%]) and 13 of 87 smokers (14.9% [CI, 10% to 26%]) who received radioiodine plus prednisone (P < 0.001). In study 2, 61 of 65 nonsmokers (93.8% [CI, 90% to 98%]) and 58 of 85 smokers (68.2% [CI, 57% to 78%]) responded to treatment (P < 0.001).
Conclusions: Cigarette smoking increases the risk for progression of ophthalmopathy after radioiodine therapy and decreases the efficacy of orbital radiation therapy and glucocorticoid therapy.
Author and Article Information
From the University of Pisa, Pisa, Italy.
BRIEF COMMUNICATION
Cigarette Smoking and Treatment Outcomes in Graves Ophthalmopathy
Grant Support: In part by grants from the University of Pisa (Fondi di Ateneo), Pisa, Italy, and from Ministero della Universita e della Ricerca Scientifica e Tecnologica (40% funding), Rome, Italy.
Requests for Reprints: Luigi Bartalena, MD, Dipartimento di Endocrinologia e Metabolismo, Ortopedia e Traumatologia, Medicina del Lavoro, University of Pisa, Ospedale Cisanello, via Paradisa, 2, 56122 Pisa, Italy; e-mail, l.bartalena@endoc.med.unipi.it.
Current Author Addresses: Drs. Bartalena, Marcocci, Tanda, Manetti, Dell'Unto, Martino, and Pinchera: Dipartimento di Endocrinologia e Metabolismo, Ortopedia e Traumatologia, Medicina del Lavoro, University of Pisa, Ospedale Cisanello, via Paradisa, 2, 56122 Pisa, Italy.
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
This article has been cited by other articles:
|
|
 |
|
  L. Bartalena and M. L. Tanda Graves' Ophthalmopathy N. Engl. J. Med., March 5, 2009; 360(10): 994 - 1001. [Full Text] [PDF]
|
|
|
|
 |
|
 N Lois, E Abdelkader, K Reglitz, C Garden, and J G Ayres Environmental tobacco smoke exposure and eye disease Br. J. Ophthalmol., October 1, 2008; 92(10): 1304 - 1310. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. Walter, M. Christ-Crain, B. Muller, M. Rotondi, R. Fonte, L. Chiovato, B. S. Levy, S. Metso, P. Jaatinen, J. Salmi, et al. Graves' disease. N. Engl. J. Med., September 25, 2008; 359(13): 1407 - 1408. [Full Text] [PDF]
|
|
|
|
 |
|
 K. K. L. Chong, S. W. Y. Chiang, G. W. K. Wong, P. O. S. Tam, T.-K. Ng, Y.-J. Hu, G. H. F. Yam, D. S. C. Lam, and C.-P. Pang Association of CTLA-4 and IL-13 Gene Polymorphisms with Graves' Disease and Ophthalmopathy in Chinese Children Invest. Ophthalmol. Vis. Sci., June 1, 2008; 49(6): 2409 - 2415. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Bartalena, L. Baldeschi, A. Dickinson, A. Eckstein, P. Kendall-Taylor, C. Marcocci, M. Mourits, P. Perros, K. Boboridis, A. Boschi, et al. Consensus statement of the European Group on Graves' orbitopathy (EUGOGO) on management of GO Eur. J. Endocrinol., March 1, 2008; 158(3): 273 - 285. [Full Text] [PDF]
|
|
|
|
|
|
I. B. Pedersen, P. Laurberg, N. Knudsen, T. Jorgensen, H. Perrild, L. Ovesen, and L. B. Rasmussen Smoking is negatively associated with the presence of thyroglobulin autoantibody and to a lesser degree with thyroid peroxidase autoantibody in serum: a population study Eur. J. Endocrinol., March 1, 2008; 158(3): 367 - 373. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. J. Cawood, P. Moriarty, C. O'Farrelly, and D. O'Shea Smoking and Thyroid-Associated Ophthalmopathy: A Novel Explanation of the Biological Link J. Clin. Endocrinol. Metab., January 1, 2007; 92(1): 59 - 64. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. K. Eckstein, M. Plicht, H. Lax, M. Neuhauser, K. Mann, S. Lederbogen, C. Heckmann, J. Esser, and N. G. Morgenthaler Thyrotropin Receptor Autoantibodies Are Independent Risk Factors for Graves' Ophthalmopathy and Help to Predict Severity and Outcome of the Disease J. Clin. Endocrinol. Metab., September 1, 2006; 91(9): 3464 - 3470. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. E Krassas and W. Wiersinga Smoking and autoimmune thyroid disease: the plot thickens. Eur. J. Endocrinol., June 1, 2006; 154(6): 777 - 780. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. E Jensen, S. J Bonnema, and L. Hegedus Glucocorticoids do not influence the effect of radioiodine therapy in Graves' disease Eur. J. Endocrinol., July 1, 2005; 153(1): 15 - 21. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D Kapoor and T H Jones Smoking and hormones in health and endocrine disorders Eur. J. Endocrinol., April 1, 2005; 152(4): 491 - 499. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. L. Wemeau, P. Caron, A. Beckers, V. Rohmer, J. Orgiazzi, F. Borson-Chazot, M. Nocaudie, P. Perimenis, S. Bisot-Locard, I. Bourdeix, et al. Octreotide (Long-Acting Release Formulation) Treatment in Patients with Graves' Orbitopathy: Clinical Results of a Four-Month, Randomized, Placebo-Controlled, Double-Blind Study J. Clin. Endocrinol. Metab., February 1, 2005; 90(2): 841 - 848. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Bartalena, C. Marcocci, and A. Pinchera Somatostatin Analogs for Graves' Ophthalmopathy: Do They Bounce Off like a Rubber Bullet? J. Clin. Endocrinol. Metab., December 1, 2004; 89(12): 5908 - 5909. [Full Text] [PDF]
|
|
|
|
 |
|
 T. Cawood, P. Moriarty, and D. O'Shea Recent developments in thyroid eye disease BMJ, August 14, 2004; 329(7462): 385 - 390. [Full Text] [PDF]
|
|
|
|
|
|
A Eckstein, B Quadbeck, G Mueller, A W Rettenmeier, R Hoermann, K Mann, P Steuhl, and J Esser Impact of smoking on the response to treatment of thyroid associated ophthalmopathy Br. J. Ophthalmol., June 1, 2003; 87(6): 773 - 776. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M Ott, N Breiter, C F Albrecht, O Pradier, C F Hess, and H Schmidberger Can contrast enhanced MRI predict the response of Graves' ophthalmopathy to orbital radiotherapy? Br. J. Radiol., June 1, 2002; 75(894): 514 - 517. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. P. Weetman Graves' Disease N. Engl. J. Med., October 26, 2000; 343(17): 1236 - 1248. [Full Text] [PDF]
|
|
|
|
 |
|
 K. A. Woeber Update on the Management of Hyperthyroidism and Hypothyroidism Arch Fam Med, August 1, 2000; 9(8): 743 - 747. [Full Text] [PDF]
|
|
|
|
 |
|
 K. A. Woeber Update on the Management of Hyperthyroidism and Hypothyroidism Arch Intern Med, April 24, 2000; 160(8): 1067 - 1071. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Bartalena, A. Pinchera, and C. Marcocci Management of Graves' Ophthalmopathy: Reality and Perspectives Endocr. Rev., April 1, 2000; 21(2): 168 - 199. [Abstract] [Full Text]
|
|
|
|
|
|
G. J. Kahaly, H.-P. Rösler, S. Pitz, and G. Hommel Low- Versus High-Dose Radiotherapy for Graves' Ophthalmopathy: A Randomized, Single Blind Trial J. Clin. Endocrinol. Metab., January 1, 2000; 85(1): 102 - 108. [Abstract] [Full Text]
|
|
|
|
 |
|
 K. A. Woeber The Year in Review: The Thyroid Ann Intern Med, December 21, 1999; 131(12): 959 - 962. [Abstract] [Full Text] [PDF]
|
|
