Treatment of Severe Gravesx Ophthalmopathy with a PPAR-ϒ Antagonist and Cyclooxigenase-2 Inhibitor: Preliminary Results

Program: Abstracts - Orals, Poster Preview Presentations, and Posters
Session: SAT 0528-0545-Thyroid Autoimmunity
Saturday, June 21, 2014: 1:00 PM-3:00 PM
Hall F (McCormick Place West Building)

Poster Board SAT-0542
Janete P Moura, MD1, Walter Bloise, MD2 and Lidia Y Mimura, MD3
1FMUSP, Sao Paulo, Brazil, 2Hosp das Clinicas Schl of Med, Sao Paulo, Brazil, 3Hosp das Clinicas FMUSP, Sao Paulo, Brazil
Introduction- We have demonstrated that PPAR-ϒ antagonist and cyclooxygenase -2 Inhibitor (sodium diclofenac) was effective to treat mild or moderate Graves´ Ophthalmopathy (GO) and also in one patient with the severe form (1,2).   Background- The aim of this report is to show the preliminary results of this treatment on 4 patients with severe GO and visual impairment. Methods and Patients findings- Four patients (3 males) with aging and CAS (clinical activity score) measured in the first approach, ranging between 44 to 61 years old and 5 to 7 respectively. Visual acuity measured by the Snellen chart of the most affected eye of all patients ranging between 0,3 to 0,8. Sodium diclofenac was administered by intramuscular injection 75mg every 12 hours in the first 7 days followed by 50 mg orally every 12 hours. Renal function was checked monthly. Results- The visual acuity improved in all patients after 7 days and returned to normal except in one patient whose visual acuity changed from 0,4 to 0,7 and is still receiving the drug.  No adverse effects were observed. The hyperthyroidism showed by one single patient was not affected by the treatment. Conclusions- If the benefits of this targeted treatment could   be validated by a controlled and expanded study it will be a safe and less expensive option for the treatment of this controversial disease.


1)     Walter Bloise; Lidia Yuri Mimura; Janete Moura; Wilian Nicolau. Treatment of mild to moderate Graves' ophthalmopathy with sodium diclofenac: a pilot study. Brazilan Archives Endocrinol Metabol, 2011; 55(9): 692-5

2)     Janete Moura, Lidia Y Mimura, Walter Bloise: Treatment of Severe Graves Ophthalmopathy with a PPAR-{gamma} Antagonist and Cylooxygenase-2 Inhibitor Endocr Rev 2012 33: SUN-431

Nothing to Disclose: JPM, WB, LYM

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