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Research finds orbital radiotherapy should not be used to treat thyroid eye disease

26 March 2018

The first NHS-led clinical trial for thyroid eye disease (TED) - also called Graves’ orbitopathy (GO) – a disfiguring condition causing protruding eyes, double vision and swelling around the eyes affecting mostly women – has shown that currently widely used, expensive and time-consuming radiotherapy treatment, does not help patients who are also given steroid tablets.

However, disease severity was reduced in patients who also received antiproliferative immunosuppressive drugs if they were able to tolerate these medications. The study, led by researchers at the Universities of Bristol and Cardiff together with Moorfields Eye Hospital in London and conducted across 11 NHS Hospitals, is published in the Lancet Diabetes & Endocrinology.

The trial took the research team ten years to complete and was funded by a group of medical research charities ( National Eye Research Centre , Above and Beyond - the charity for Bristol's city centre hospitals, and Moorfields Eye Charity ) underpinned by the research infrastructure of the NHS.

Dr Richard Lee , Consultant Senior Lecturer in the Bristol Medical School: THS and deputy director, NIHR Moorfields Clinical Research Facility said: “CIRTED (combined immunosuppression and radiotherapy in thyroid eye disease) is the only multi-centre UK trial to have been conducted into this disfiguring and visually disabling condition.”

“Our research was jointly published with the MINGO trial , which both support the use of antiproliferative immunosuppressive drugs in patients with TED.”

Professor Colin Dayan and Dr Peter Taylor , from the School of Medicine at Cardiff University, added: “The CIRTED and MINGO trials found that TED patients treated with steroids would also benefit from an antiproliferative drug, such as Mycophenolate, and they should not receive orbital radiotherapy.”

Paper

Combined immunosuppression and radiotherapy in thyroid eye disease (CIRTED): a multicentre, 2 × 2 factorial, double-blind, randomised controlled trial’ by R Rajendram et al in The Lancet Diabetes & Endocrinology

Research finds orbital radiotherapy should not be used to treat thyroid eye disease
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