Your browser has javascript turned off or blocked. This will lead to some parts of our website to not work properly or at all. Turn on javascript for best performance.

The browser you are using is not supported by this website. All versions of Internet Explorer are no longer supported, either by us or Microsoft (read more here: https://www.microsoft.com/en-us/microsoft-365/windows/end-of-ie-support).

Please use a modern browser to fully experience our website, such as the newest versions of Edge, Chrome, Firefox or Safari etc.

Default user image.

Tereza Planck

Physician

Default user image.

Adjuvant Treatment of Graves' Disease with Diclofenac : Safety, Effects on Ophthalmopathy and Antibody Concentrations

Author

  • Mikael Lantz
  • Jan Calissendorff
  • Frank Träisk
  • Leif Tallstedt
  • Tereza Planck
  • Ove Törring
  • Bengt Hallengren
  • Peter Åsman

Summary, in English

BACKGROUND: Orbital morphological changes are often present in patients with Graves' disease (GD) already at diagnosis, and cyclooxygenase type 2 (COX-2) is overexpressed in active Graves' ophthalmopathy (GO).

OBJECTIVE: To investigate if adjuvant treatment of GD with the COX inhibitor and peroxisome proliferator-activated receptor-γ (PPAR-γ) antagonist diclofenac decreases the development of ophthalmopathy and if laboratory parameters are affected.

METHODS: This is a multicenter trial where 61 subjects were randomized to methimazole (block and replace with l-thyroxine) either with or without diclofenac 50 mg 1 × 2 for 12 months. The primary end point development of GO after 24 months was evaluated. Smoking habits were registered and the thyroid parameters TSH, free T4, free T3, TSH receptor antibodies (TRAb) and anti-TPO were followed. Safety parameters (kidney, liver and blood) and adverse events were regularly registered.

RESULTS: GO developed in 11% (n = 3) of the patients treated with diclofenac and in 21% (n = 6) of the controls (p = 0.273). The adverse event profile was acceptable without any severe events related to diclofenac. Both TRAb and anti-TPO concentrations decreased during treatment with methimazole, but the anti-TPO concentrations were lower in patients treated with diclofenac after 15 months (p = 0.031). The TRAb concentrations were not significantly changed between groups. Smokers had higher concentrations of TRAb than nonsmokers both at diagnosis of GD (p = 0.048) and after 15 months (p = 0.042).

CONCLUSIONS: Treatment with diclofenac had no significant influence on development of GO. Diclofenac reduces anti-TPO concentrations and seems to be safe to use in GD patients.

Department/s

  • Genomics, Diabetes and Endocrinology
  • Ophthalmology (Malmö)

Publishing year

2016-03

Language

English

Pages

6-50

Publication/Series

European Thyroid Journal

Volume

5

Issue

1

Document type

Journal article

Publisher

Karger

Topic

  • Endocrinology and Diabetes
  • Ophthalmology

Status

Published

Research group

  • Genomics, Diabetes and Endocrinology
  • Ophthalmology (Malmö)

ISBN/ISSN/Other

  • ISSN: 2235-0640