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

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