{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:47:56Z","timestamp":1787021276865,"version":"build-2736575974"},"reference-count":35,"publisher":"The Endocrine Society","issue":"1","license":[{"start":{"date-parts":[[2023,8,14]],"date-time":"2023-08-14T00:00:00Z","timestamp":1691971200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100010096","name":"Southern Medical University","doi-asserted-by":"publisher","award":["LC2016PY046"],"award-info":[{"award-number":["LC2016PY046"]}],"id":[{"id":"10.13039\/501100010096","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Guangdong Science and Technology Plan Project","award":["2019B020230001"],"award-info":[{"award-number":["2019B020230001"]}]},{"name":"China Health Promotion Foundation Thyroid Research Project for Young and Middle-aged Doctors"},{"name":"Guangdong Province key Field Research and Development Plan Project","award":["2016KZDXM019"],"award-info":[{"award-number":["2016KZDXM019"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,21]]},"abstract":"Abstract<\/jats:title>\n \n Context<\/jats:title>\n Intravenous glucocorticoid (IVGC) is an accessible and affordable treatment for Graves orbitopathy (GO); the 4.5-g protocol is well studied, but many details of treatment protocols need to be clarified.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To compare the efficacy and safety of weekly and monthly protocol of IVGC in GO.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A prospective, randomized, observer-masked, single-center clinical trial, followed up to week 24, at the third affiliated hospital of Southern Medical University; 58 patients with active and moderate to severe GO, aged 18-60 years old, who had not received relevant treatment were included. The intervention was weekly protocol or monthly protocol of IVGC; both received a cumulative dose of methylprednisolone 4.5 g and had a duration of 12 weeks. The overall effective rate, improvement of quality of life (QOL) and signal intensity ratio (SIR) were measured.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n There was no significant difference in the effective rate between the 2 groups at week 12 and week 24 (86.21% vs 72.41%, P = .195; 86.21% vs 82.61%, P = .441), there was no significant difference in the improvement of clinical activity score, exophthalmos, soft tissue involvement, diplopia, and QOL. At week 24, the mean SIR and maximum SIR of the 2 groups were lower than those before treatment, and there were no statistically significant difference between the 2 groups. There was no significant difference in the incidence of adverse events between the 2 groups (31.03% vs 27.59%, P = .773).<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The efficacy and safety of the 2 protocols are comparable; the monthly protocol could be used as an alternative to the weekly protocol.<\/jats:p>\n <\/jats:sec>","DOI":"10.1210\/clinem\/dgad476","type":"journal-article","created":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T17:00:41Z","timestamp":1691686841000},"page":"36-45","source":"Crossref","is-referenced-by-count":4,"title":["A Randomized Clinical Trial of Intravenous Methylprednisolone With 2 Protocols in Patients With Graves Orbitopathy"],"prefix":"10.1210","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8455-7970","authenticated-orcid":false,"given":"Zhangfang","family":"Li","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Southern Medical University , Guangzhou, Guangdong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0958-1839","authenticated-orcid":false,"given":"Yaosheng","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People\u2019s Hospital of Shunde) , Foshan, Guangdong , China"},{"name":"Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University , Guangzhou, Guangdong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quandi","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Southern Medical University , Guangzhou, Guangdong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Southern Medical University , Guangzhou, Guangdong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dandan","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Southern Medical University , Guangzhou, Guangdong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daoyan","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Southern Medical University , Guangzhou, Guangdong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shidi","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Southern Medical University , Guangzhou, Guangdong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Southern Medical University , Guangzhou, Guangdong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiuyue","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Southern Medical University , Guangzhou, Guangdong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoting","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Southern Medical University , Guangzhou, Guangdong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Southern Medical University , Guangzhou, Guangdong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chanyan","family":"Weng","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Southern Medical University , Guangzhou, Guangdong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Southern Medical University , Guangzhou, Guangdong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tongfeng","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Southern Medical University , Guangzhou, Guangdong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8514-7674","authenticated-orcid":false,"given":"Chenzhong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Southern Medical University , Guangzhou, Guangdong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4235-3651","authenticated-orcid":false,"given":"Tong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Southern Medical University , Guangzhou, Guangdong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6952-9541","authenticated-orcid":false,"given":"Jie","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Southern Medical University , Guangzhou, Guangdong , China"},{"name":"Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People\u2019s Hospital of Shunde) , Foshan, Guangdong , China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2023,8,14]]},"reference":[{"issue":"5","key":"2023122122203898300_dgad476-B1","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1111\/joim.13524","article-title":"Current concepts regarding Graves\u2019 orbitopathy","volume":"292","author":"Bartalena","year":"2022","journal-title":"J Intern Med"},{"key":"2023122122203898300_dgad476-B2","doi-asserted-by":"crossref","first-page":"615993","DOI":"10.3389\/fendo.2020.615993","article-title":"Epidemiology, natural history, risk factors, and prevention of Graves\u2019 orbitopathy","volume":"11","author":"Bartalena","year":"2020","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"16","key":"2023122122203898300_dgad476-B3","doi-asserted-by":"crossref","first-page":"1552","DOI":"10.1056\/NEJMra1510030","article-title":"Graves\u2019 disease","volume":"375","author":"Smith","year":"2016","journal-title":"N Engl J Med"},{"issue":"12","key":"2023122122203898300_dgad476-B4","doi-asserted-by":"crossref","first-page":"4454","DOI":"10.1210\/jc.2012-2389","article-title":"Efficacy and safety of three different cumulative doses of intravenous methylprednisolone for moderate to severe and active Graves\u2019 orbitopathy","volume":"97","author":"Bartalena","year":"2012","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"2023122122203898300_dgad476-B5","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/j.beem.2011.11.001","article-title":"Quality of life in Graves\u2019 ophthalmopathy","volume":"26","author":"Wiersinga","year":"2012","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"issue":"4","key":"2023122122203898300_dgad476-B6","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1056\/NEJMoa1910434","article-title":"Teprotumumab for the treatment of active thyroid eye disease","volume":"382","author":"Douglas","year":"2020","journal-title":"N Engl J Med"},{"key":"2023122122203898300_dgad476-B7","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.ajo.2018.07.038","article-title":"Efficacy of tocilizumab in patients with moderate-to-severe corticosteroid-resistant Graves orbitopathy: a randomized clinical trial","volume":"195","author":"Perez-Moreiras","year":"2018","journal-title":"Am J Ophthalmol"},{"issue":"12","key":"2023122122203898300_dgad476-B8","doi-asserted-by":"crossref","first-page":"e220303","DOI":"10.1530\/EC-22-0303","article-title":"Rituximab in the treatment of Graves\u2019 orbitopathy: latest updates and perspectives","volume":"11","author":"Supronik","year":"2022","journal-title":"Endocr Connect"},{"issue":"4","key":"2023122122203898300_dgad476-B9","doi-asserted-by":"crossref","first-page":"G43","DOI":"10.1530\/EJE-21-0479","article-title":"The 2021 European group on Graves\u2019 orbitopathy (EUGOGO) clinical practice guidelines for the medical management of Graves\u2019 orbitopathy","volume":"185","author":"Bartalena","year":"2021","journal-title":"Eur J Endocrinol"},{"issue":"9","key":"2023122122203898300_dgad476-B10","first-page":"646","article-title":"[Chinese guideline on the diagnosis and treatment of thyroid-associated ophthalmopathy (2022)]","volume":"58","author":"Oculoplastic, Orbital Disease Group of Chinese Ophthalmological Society of Chinese Medical A, Thyroid Group of Chinese Society of Endocrinology of Chinese Medical A","year":"2022","journal-title":"Zhonghua Yan Ke Za Zhi"},{"issue":"12","key":"2023122122203898300_dgad476-B11","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1089\/thy.2022.0251","article-title":"Management of thyroid eye disease: a consensus statement by the American thyroid association and the European thyroid association","volume":"32","author":"Burch","year":"2022","journal-title":"Thyroid"},{"issue":"2","key":"2023122122203898300_dgad476-B12","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1210\/jc.2010-1962","article-title":"Clinical review: intravenous glucocorticoids for Graves\u2019 orbitopathy: efficacy and morbidity","volume":"96","author":"Zang","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"issue":"12","key":"2023122122203898300_dgad476-B13","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1507\/endocrj.EJ16-0165","article-title":"Is modified clinical activity score an accurate indicator of diplopia progression in Graves\u2019 orbitopathy patients?","volume":"63","author":"Kim","year":"2016","journal-title":"Endocr J"},{"issue":"1","key":"2023122122203898300_dgad476-B14","doi-asserted-by":"crossref","first-page":"16874","DOI":"10.1038\/s41598-017-17257-6","article-title":"Quantitative analysis of inflammation in orbital fat of thyroid-associated ophthalmopathy using MRI signal intensity","volume":"7","author":"Higashiyama","year":"2017","journal-title":"Sci Rep"},{"issue":"5","key":"2023122122203898300_dgad476-B15","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1007\/s00234-014-1332-4","article-title":"Diagnostic accuracy of short-time inversion recovery sequence in Graves\u2019 ophthalmopathy before and after prednisone treatment","volume":"56","author":"Tortora","year":"2014","journal-title":"Neuroradiology"},{"issue":"1","key":"2023122122203898300_dgad476-B16","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1186\/s12902-021-00895-3","article-title":"Quantitative evaluation of activity of thyroid-associated ophthalmopathy using short-tau inversion recovery (STIR) sequence","volume":"21","author":"Ge","year":"2021","journal-title":"BMC Endocr Disord"},{"issue":"3","key":"2023122122203898300_dgad476-B17","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1038\/eye.2001.102","article-title":"Serial STIR magnetic resonance imaging correlates with clinical score of activity in thyroid disease","volume":"15","author":"Mayer","year":"2001","journal-title":"Eye (Lond)"},{"issue":"2","key":"2023122122203898300_dgad476-B18","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1007\/s10384-014-0365-x","article-title":"Use of MRI signal intensity of extraocular muscles to evaluate methylprednisolone pulse therapy in thyroid-associated ophthalmopathy","volume":"59","author":"Higashiyama","year":"2015","journal-title":"Jpn J Ophthalmol"},{"key":"2023122122203898300_dgad476-B19","doi-asserted-by":"crossref","first-page":"2277","DOI":"10.2147\/OPTH.S118555","article-title":"Clinical and imaging evaluation of the response to intravenous steroids in patients with Graves\u2019 orbitopathy and analysis on who requires additional therapy","volume":"10","author":"Tsirouki","year":"2016","journal-title":"Clin Ophthalmol"},{"issue":"3","key":"2023122122203898300_dgad476-B20","first-page":"143","article-title":"[Prediction for effectiveness of steroid pulse therapy by MRI in Graves\u2019 ophthalmopathy]","volume":"68","author":"Sato","year":"1992","journal-title":"Nihon Naibunpi Gakkai Zasshi"},{"issue":"1","key":"2023122122203898300_dgad476-B21","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1046\/j.1365-2265.1997.2331047.x","article-title":"Clinical activity score as a guide in the management of patients with Graves\u2019 ophthalmopathy","volume":"47","author":"Mourits","year":"1997","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"7","key":"2023122122203898300_dgad476-B22","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1136\/bjo.82.7.773","article-title":"Development of a disease specific quality of life questionnaire for patients with Graves\u2019 ophthalmopathy: the GO-QOL","volume":"82","author":"Terwee","year":"1998","journal-title":"Br J Ophthalmol"},{"issue":"3","key":"2023122122203898300_dgad476-B23","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1046\/j.1365-2265.2001.01241.x","article-title":"Interpretation and validity of changes in scores on the Graves\u2019 ophthalmopathy quality of life questionnaire (GO-QOL) after different treatments","volume":"54","author":"Terwee","year":"2001","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"Suppl 1","key":"2023122122203898300_dgad476-B24","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1159\/000510700","article-title":"Proposal for standardization of primary and secondary outcomes in patients with active, moderate-to-severe Graves\u2019 orbitopathy","volume":"9","author":"Bartalena","year":"2020","journal-title":"Eur Thyroid J"},{"key":"2023122122203898300_dgad476-B25","author":"Li"},{"issue":"6","key":"2023122122203898300_dgad476-B26","doi-asserted-by":"crossref","first-page":"153","DOI":"10.3892\/etm.2020.9282","article-title":"Comparison of two regimens for patients with thyroid-associated ophthalmopathy receiving intravenous methyl prednisolone: a single center prospective randomized trial","volume":"20","author":"Mu","year":"2020","journal-title":"Exp Ther Med"},{"issue":"6","key":"2023122122203898300_dgad476-B27","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1210\/jc.2013-3919","article-title":"A prospective, randomized trial of intravenous glucocorticoids therapy with different protocols for patients with graves\u2019 ophthalmopathy","volume":"99","author":"Zhu","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"issue":"5","key":"2023122122203898300_dgad476-B28","doi-asserted-by":"crossref","first-page":"e220017","DOI":"10.1530\/ETJ-22-0017","article-title":"Methotrexate plus reduced or full-dose glucocorticoids for the treatment of active, moderate-to-severe Graves\u2019 orbitopathy","volume":"11","author":"Shen","year":"2022","journal-title":"Eur Thyroid J"},{"issue":"8","key":"2023122122203898300_dgad476-B29","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1111\/ceo.12317","article-title":"Meta-analysis of methylprednisolone pulse therapy for Graves\u2019 ophthalmopathy","volume":"42","author":"Gao","year":"2014","journal-title":"Clin Exp Ophthalmol"},{"issue":"2","key":"2023122122203898300_dgad476-B30","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1507\/endocrj.EJ16-0083","article-title":"Comparison of two different regimens of intravenous methylprednisolone for patients with moderate to severe and active Graves\u2019 ophthalmopathy: a prospective, randomized controlled trial","volume":"64","author":"He","year":"2017","journal-title":"Endocr J"},{"issue":"6","key":"2023122122203898300_dgad476-B31","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1016\/S2213-8587(21)00056-5","article-title":"Teprotumumab for patients with active thyroid eye disease: a pooled data analysis, subgroup analyses, and off-treatment follow-up results from two randomised, double-masked, placebo-controlled, multicentre trials","volume":"9","author":"Kahaly","year":"2021","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"18","key":"2023122122203898300_dgad476-B32","doi-asserted-by":"crossref","first-page":"1748","DOI":"10.1056\/NEJMoa1614949","article-title":"Teprotumumab for thyroid-associated ophthalmopathy","volume":"376","author":"Smith","year":"2017","journal-title":"N Engl J Med"},{"issue":"4","key":"2023122122203898300_dgad476-B33","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1177\/112067210401400401","article-title":"Pentoxifylline (PTX)\u2013an alternative treatment in Graves\u2019 ophthalmopathy (inactive phase): assessment by a disease specific quality of life questionnaire and by exophthalmometry in a prospective randomized trial","volume":"14","author":"Finamor","year":"2004","journal-title":"Eur J Ophthalmol"},{"issue":"1","key":"2023122122203898300_dgad476-B34","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1210\/jc.2003-030809","article-title":"A randomized controlled trial of orbital radiotherapy versus sham irradiation in patients with mild Graves\u2019 ophthalmopathy","volume":"89","author":"Prummel","year":"2004","journal-title":"J Clin Endocrinol Metab"},{"key":"2023122122203898300_dgad476-B35","doi-asserted-by":"crossref","DOI":"10.1002\/jmri.28642","article-title":"Application of multiparameter quantitative magnetic resonance imaging in the evaluation of Graves\u201d ophthalmopathy","author":"Li","year":"2023","journal-title":"J Magn Reson Imaging"}],"container-title":["The Journal of Clinical Endocrinology & Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/clinem\/dgad476\/51532931\/dgad476.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/109\/1\/36\/54731817\/dgad476.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/109\/1\/36\/54731817\/dgad476.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T20:58:16Z","timestamp":1729889896000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/109\/1\/36\/7242468"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,14]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,8,14]]},"published-print":{"date-parts":[[2023,12,21]]}},"URL":"https:\/\/doi.org\/10.1210\/clinem\/dgad476","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,1]]},"published":{"date-parts":[[2023,8,14]]}}}