Selenium beneficial for mild Graves' orbitopathy

January 01, 0001

Selenium beneficial for mild Graves' orbitopathy

Oxygen free radicals and cytokines play a pathogenic role in Graves' orbitopathy. These authors from multiple European countries carried out a randomized, double-blind, placebo-controlled trial to determine the effect of selenium (an antioxidant agent) or pentoxifylline (an antiinflammatory agent) in 159 patients with mild Graves' orbitopathy. The patients were given selenium (100 mcg twice daily), pentoxifylline (600 mg twice daily), or placebo (twice daily) orally for 6 months and were then followed for 6 months after treatment was withdrawn. Primary outcomes at 6 months were evaluated by means of an overall ophthalmic assessment, conducted by an ophthalmologist who was unaware of the treatment assignments, and patient self-report.

They found: "At the 6-month evaluation, treatment with selenium, but not with pentoxifylline, was associated with an improved quality of life and less eye involvement and slowed the progression of Graves' orbitopathy, as compared with placebo. The Clinical Activity Score decreased in all groups, but the change was significantly greater in the selenium-treated patients. Exploratory evaluations at 12 months confirmed the results seen at 6 months. Two patients assigned to placebo and one assigned to pentoxifylline required immunosuppressive therapy for deterioration in their condition. No adverse events were evident with selenium, whereas pentoxifylline was associated with frequent gastrointestinal problems."

The authors concluded: "Selenium administration significantly improved quality of life, reduced ocular involvement, and slowed progression of the disease in patients with mild Graves' orbitopathy."

Good evidence of benefit of selenium to limit Graves’ orbitophathy.

For the full abstract, click here.

N Engl J Med 364:1920-1931, 19 May 2011 © 2011 to the Massachusetts Medical Society
Selenium and the Course of Mild Graves' Orbitopathy. Claudio Marcocci, George J. Kahaly, Gerasimos E. Krassas, et al. Correspondence to Dr. Marcocci: [email protected]

Category: F. Eye. Keywords: Graves’ disease, orbitopathy, selenium, pentoxifylline, randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 31 May 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.