Table 1.
Applicable survey items for management recommendations for TED.
Questions | Response options |
---|---|
GD patients with mild active TED and a CAS of three points present a management challenge. Do you have a preference regarding first-line treatment for hyperthyroidism? | Anti-thyroid drugs, radioiodine, radioiodine plus oral steroid prophylaxis, and thyroidectomy. |
For GD patients with mild active TED, what would be your treatment recommendation(s) at this stage for TED? (you may check more than one box if you wish) | Treating hyperthyroidism alone, intravenous corticosteroids, orbital corticosteroids injection, oral corticosteroids, mycophenolate, rituximab, tocilizumab, teprotumumab, rapamycin, cyclosporin, azathioprine, methotrexate, orbital surgery, orbital radiotherapy, and statin therapy. |
For patients with moderate-to-severe active TED, which treatment is the first-line treatment? | Intravenous corticosteroids, orbital corticosteroids injection, oral corticosteroids, mycophenolate, rituximab, tocilizumab, teprotumumab, rapamycin, cyclosporin, azathioprine, methotrexate, orbital surgery, and orbital radiotherapy. |
Before and after administering intravenous corticosteroids therapy, which indicators would you evaluate in order to prevent adverse reactions in patients? (you may check more than one box if you wish) | Complete blood count, urinalysis, liver function, kidney function, blood glucose, electrolytes, blood coagulation function, indicators related to viral and autoimmune hepatitis, blood pressure, electrocardiogram, chest X-ray or CT scan, and bone density measurement. |
What is your most commonly used corticosteroid dosage for moderate-to-severe active TED patients receiving intravenous corticosteroids treatment? | 0.5 g/week intravenous methylprednisolone for six consecutive weeks, followed by 0.25 g/week for 6 weeks, 0.5 g/week intravenous methylprednisolone for six consecutive weeks, followed by 0.25 g/week for 6 weeks plus oral mycophenolate, 0.75 g/week intravenous methylprednisolone for six consecutive weeks, followed by 0.5 g/week for 6 weeks, 0.5–1 g/day intravenous methylprednisolone daily or every other day (repeat three times for 1–2 weeks), followed by tapering dose of oral prednisolone |
What is your preferred treatment approach for TED patients with DON? | 0.75 g/week intravenous methylprednisolone for six consecutive weeks, followed by 0.5 g/week for 6 weeks, 0.5–1 g/day intravenous methylprednisolone daily or every other day (repeat three times for 1–2 weeks), followed by tapering dose of oral prednisolone, urgent eye surgery, and elective eye surgery, 0.5–1 g/day intravenous methylprednisolone daily or every other day (repeat three times for 1–2 weeks), conduct eye surgery if no improvement, tocilizumab as the initial treatment, followed by eye surgery if no improvement. |
For type 2 diabetes patients with poor control of blood glucose levels, what treatment(s) would you institute as first line for TED? (you may check more than one if you wish) | Antidiabetic medication plus intravenous corticosteroids, orbital corticosteroids injection, oral corticosteroids, mycophenolate, rituximab, tocilizumab, teprotumumab, rapamycin, cyclosporin, azathioprine, methotrexate, orbital surgery, and orbital radiotherapy. |
CAS, clinical activity score; DON, dysthyroid optic neuropathy; GD, Graves’ disease; TED, thyroid eye disease.