{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T16:23:33Z","timestamp":1792167813127,"version":"4.4.0"},"reference-count":26,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2014,10,1]],"date-time":"2014-10-01T00:00:00Z","timestamp":1412121600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Glucocorticoid (GC) therapy has been shown to prevent Graves' ophthalmopathy (GO) progression following radioactive iodine (RAI) treatment. However, the optimal regimen is controversial, with studies from recent years suggesting the use of lower doses and shorter GC treatment courses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and retrospective controlled trials comparing GC regimens versus placebo, no treatment, or other GC regimens.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Eight trials evaluating 850 patients fulfilled inclusion criteria. In patients with preexisting GO, standard dose prednisone (0.4\u20130.5\u2009mg\/kg tapered over 3 months) was very effective for prevention of GO progression (OR 0.14 [CI 0.06\u20130.35],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt;0.01) in patients with mild to moderate GO. Two studies evaluated low-dose prednisone (0.2\u20130.3\u2009mg\/kg for 4\u20136 weeks) in patients with mild GO or risk factors, but were limited by not including patients with preexisting GO in the control groups. Therefore, the two low-dose groups were evaluated using indirect comparisons with control groups matched for age and clinical activity score, showing excellent efficacy versus no treatment or placebo (OR 0.20 [CI 0.07\u20130.60],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      =0.004) and no significant difference compared with standard dose (OR 1.7 [CI 0.52\u20135.52],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      =0.47). In patients without preexisting GO, steroid prophylaxis had no beneficial effect (OR 1.87 [CI 0.81\u20134.3]), though there were insufficient data regarding patients with risk factors for GO development. GC prophylaxis had no impact on hyperthyroidism resolution (OR 1.05 [CI 0.69\u20131.58]), and GC side effects were common but mild.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Current evidence supports a three-tier approach for prevention of GO progression following RAI. Standard dose prednisone is the best validated regimen and should be used in patients with mild to moderate GO who have high risk of progression, while low dose prednisone can be used in patients with mild GO, and in patients without preexisting GO who have risk factors and are selected for GC prophylaxis. Patients without preexisting GO and without risk factors should not be treated with GC prophylaxis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/thy.2014.0218","type":"journal-article","created":{"date-parts":[[2014,7,28]],"date-time":"2014-07-28T11:08:50Z","timestamp":1406545730000},"page":"1515-1523","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":62,"title":["Glucocorticoid Regimens for Prevention of Graves' Ophthalmopathy Progression Following Radioiodine Treatment: Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"24","author":[{"given":"Shachaf","family":"Shiber","sequence":"first","affiliation":[{"name":"Beilinson Hospital","place":["Israel"]},{"name":"Tel Aviv University","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hadas","family":"Stiebel-Kalish","sequence":"additional","affiliation":[{"name":"Tel Aviv University","place":["Israel"]},{"name":"Beilinson Hospital","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilan","family":"Shimon","sequence":"additional","affiliation":[{"name":"Tel Aviv University","place":["Israel"]},{"name":"Beilinson Hospital","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alon","family":"Grossman","sequence":"additional","affiliation":[{"name":"Tel Aviv University","place":["Israel"]},{"name":"Beilinson Hospital","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eyal","family":"Robenshtok","sequence":"additional","affiliation":[{"name":"Tel Aviv University","place":["Israel"]},{"name":"Beilinson Hospital","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2014,10,1]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.107.049437"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(89)80485-1"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199801083380201"},{"key":"e_1_3_3_5_2","first-page":"542","article-title":"The incidence of ophthalmopathy after radioiodine therapy for Graves' disease: prognostic factors and the role of methimazole","volume":"79","author":"Kung AW","year":"1994","unstructured":"Kung AW, , Yau CC, , Cheng A. 1994. The incidence of ophthalmopathy after radioiodine therapy for Graves' disease: prognostic factors and the role of methimazole. J Clin Endocrinol Metab, 79:542\u2013546.","journal-title":"J Clin Endocrinol Metab"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2008.03279.x"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199206253262603"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(89)90288-2"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1530\/eje.1.01938"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2009-0506"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198911163212001"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2009-2130"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1530\/eje.1.01924"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2007.0315"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.4158\/EP.17.3.456"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1530\/eje.1.02201"},{"key":"e_1_3_3_17_2","unstructured":"Cochrane Handbook for Systematic Reviews of Interventions 5.1.0. Available at: www.cochrane.org\/resources\/handbook (accessed January2014)."},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-73-1-125"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-62-4-773"},{"key":"e_1_3_3_21_2","first-page":"165","article-title":"Emprego profil\u00e1tico de cortic\u00f3ide na preven\u00e7\u00e4o da progress\u00e4 da oftalmopatia de Graves ap\u00f3s tratamento do hipertireoidismo com iodo radioativo [Corticosteroids therapy to prevent progression of Graves' ophthalmopathy after treatment of hyperthyroidism with radioiodine.]","volume":"115","author":"Vaisman M","year":"1997","unstructured":"Vaisman M. 1997. Emprego profil\u00e1tico de cortic\u00f3ide na preven\u00e7\u00e4o da progress\u00e4 da oftalmopatia de Graves ap\u00f3s tratamento do hipertireoidismo com iodo radioativo [Corticosteroids therapy to prevent progression of Graves' ophthalmopathy after treatment of hyperthyroidism with radioiodine.]. Folha m\u00e9d, 115:165\u2013167.","journal-title":"Folha m\u00e9d"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-0507"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2009-0747"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1530\/eje.0.1300494"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2010.1640"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-3873"},{"key":"e_1_3_3_27_2","first-page":"444","article-title":"Prevalence and natural history of Graves' orbitopathy in the XXI century","volume":"36","author":"Piantanida E","year":"2013","unstructured":"Piantanida E, , Tanda ML, , Lai A, , Sassi L, , Bartalena L. 2013. Prevalence and natural history of Graves' orbitopathy in the XXI century. J Endocrinol Invest, 36:444\u2013449.","journal-title":"J Endocrinol Invest"}],"container-title":["Thyroid\u00ae"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/thy.2014.0218","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/thy.2014.0218","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/thy.2014.0218","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T05:58:16Z","timestamp":1777701496000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/thy.2014.0218"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,10]]},"references-count":26,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2014,10]]}},"alternative-id":["10.1089\/thy.2014.0218"],"URL":"https:\/\/doi.org\/10.1089\/thy.2014.0218","relation":{},"ISSN":["1050-7256","1557-9077"],"issn-type":[{"value":"1050-7256","type":"print"},{"value":"1557-9077","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,10]]}}}