EP1671 - ECE_2171 - A network meta-analysis of the therapeutic efficacy for moderate to severe active thyroid-associated ophthalmopathy
Year: 2026
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: Objective To evaluate the safety and efficacy of various treatment modalities for thyroid-associated ophthalmopathy through a network meta-analysis. Methods A literature search was conducted in multiple databases including PubMed, Web of Science, EMBASE, and Cochrane Library up to December 31, 2024, for randomized controlled trials involving patients with moderate to severe active thyroid-associated ophthalmopathy. The quality of the included studies was evaluated using the Cochrane Risk of Bias tool (RoB 2). Network meta-analysis based on the frequentist approach was performed using RevMan 5.3 and STATA 15.0 software. The primary outcome measures were overall response rate, clinical activity score (CAS), proptosis, palpebral fissure height, diplopia, and adverse reactions. Result Eventually, we included 26 eligible randomized controlled studies, involving a total of 1561 participants, covering a total of 16 intervention methods, including intravenous glucocorticoid injection (IVGC), oral glucocorticoid (OGC), retrobulbar glucocorticoid injection (TA), orbital radiotherapy (OR), somatostatin analogues (SSA), and biological agents such as tislelizumab, etc. Network analysis showed that tislelizumab outperformed the placebo in improving clinical activity scores, exophthalmos degree, and overall response rate. Glucocorticoid combined with statins and mycophenolate mofetil treatment could improve the exophthalmos degree, quality of life score, and diplopia score of patients. Conclusion Compared with no treatment, tiotropium bromide shows a significant effect in increasing the overall treatment response rate. The method of oral mycophenolate mofetil or statins combined with intravenous glucocorticoid administration is more effective in improving exophthalmos and diplopia in patients. Although some treatment methods have shown good effects in the treatment of thyroid-associated ophthalmopathy, the adverse reactions that occur raise safety concerns, and a more ideal balance between the efficacy and safety of the treatment methods needs to be sought.
Institution: Peking University Third Hospital
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,292
OpenAlex ID: W7213269538