Effect of octreotide treatment on Graves' ophthalmopathy

In this study, nine patients with Graves' ophthalmopathy with positive clin ical activity score (CAS), who were either unresponsive or not suitable for glucocorticoid treatment, were given 100 mu g of octreotide three times da ily, subcutaneously, for three months. The mean age was 49+/-13 years. All patients were under either propylthiouracil or methimazole therapy and were euthyroid for at least one month prior to the start of the octreotide trea tment. The mean degree of proptosis as measured with the Hertel exophthalno meter decreased slightly after the treatment (22.0+/-3.0 vs 19.6+/-2.4 for the right eye and 22.2+/-1.9 vs 20.2+/-2.2 for the left eye; p<0.05). The m ean activity score decreased from 3.2+/-0.8 to 1.7+/-1.1 (p<0.005) and the mean score of eye signs according to the NOSPECS classification showed impr ovement with octreotide therapy (3.2+/-0.7 vs. 2.2+/-1.4; p<0.05). Seven pa tients responded favorably to octreotide treatment. In the remaining two no improvement was observed. Four of the responders could be followed up for 20 months after the treatment and all maintained the favorable state of eye findings obtained with octreotide. We conclude that octreotide seems to be a safe and effective drug in Graves' ophthalmopathy, especially in improvi ng soft tissue involvement, and can be used in patients who are unresponsiv e to glucocorticoid treatment or who cannot use these drugs for some reason .