Researchers find new way to attack inflammation in Graves' eye disease

Nov 06, 2009

A small group of patients with severe Graves' eye disease experienced rapid improvement of their symptoms — and improved vision — following treatment with the drug rituximab. Inflammation around their eyes and damage to the optic nerve were significantly reduced. The same patients had not previously responded to steroids, a common treatment for Graves' eye disease.

Raymond S. Douglas, M.D., Ph.D., an oculoplastics specialist who recently joined the faculty of the U-M Kellogg Eye Center, reports on the potential of the drug in the online October issue of Ophthalmology. Douglas reviewed the progress of six patients he treated while on the faculty of the University of California at Los Angeles.

Graves' is an autoimmune disease that causes inflammation and fatty deposits in the eye muscles and connective tissue surrounding the eye. Among the symptoms are pronounced bulging eyes, retracted eyelids, dry eyes, and, in severe cases, loss of vision. Women are more likely than men to develop the disease.

The study suggests that rituximab is a potentially effective new treatment for the most severe forms of Graves' eye disease. "These patients had already received the maximum level of steroid treatment," says Douglas. "Treatment with rituximab calmed inflammation, stopped progression of the disease, and saved the patients from having to undergo surgery."

Rituximab has been used to treat patients with other autoimmune diseases, including and in non-Hodgkin's . The drug works by depleting B cells—the body's normal antibody-producing cells—that appear to go awry in .

Collaborating with Terry J. Smith, M.D., the Frederick G.L. Huetwell Professor of Ophthalmology and Visual Sciences, Douglas has helped to explain the process by which the immune system attacks the orbital tissue in Graves' eye disease. In an earlier study, the researchers reported that play a pivotal role in the inflammatory process in Graves' eye disease.

In the current study, Douglas observed improvement among the patients, four of whom were women, as early as four weeks following the first infusion of rituximab. Researchers also observed that the positive results were sustained 4 to 6 months after treatment.

"Treatment of the inflammatory component of Graves' eye disease has not advanced appreciably over several decades," says Douglas. High-dose steroids, sometimes in combination with orbital radiation, are still the first line treatment. But, says Douglas, "These are imperfect options because inflammation often recurs when the treatment ends." He is hopeful that rituximab can offer sustained improvement.
Douglas observes that the results from a small case series must be viewed with some caution. But given the substantial benefits for patients treated with rituximab, he sees good reason to proceed with a large-scale clinical trial to test this promising new drug.

More information: Rituximab treatment of patients with severe, cortiocosteroid-resistant thyroid-associated ophthalmopathy, Ophthalmology. The paper will appear in the January print edition. DOI: 10.1016/j.ophtha.2009.05.029

Source: University of Michigan Health System (news : web)

Explore further: West Africa's Ebola outbreak prompts changes in I.Coast cuisine

add to favorites email to friend print save as pdf

Related Stories

Rituximab reduces kidney inflammation in patients with lupus

Mar 04, 2009

Treatment with the targeted drug rituximab can significantly benefit some patients with severe lupus nephritis who do not respond to conventional therapy, according to a study appearing in an upcoming issue of the Clinical Jo ...

Study reports success in treating a rare retinal disorder

Apr 13, 2009

Patients with a rare, blinding eye disease saw their vision improve after treatment with drugs to suppress their immune systems, according to researchers at the University of Michigan Kellogg Eye Center. Because autoimmune ...

Knocking Out Survival Protein Could Aid Leukemia Treatment

Apr 23, 2007

An effective way to fight leukemia might be to knock out a specific protein that protects cancer cells from dying, a new study shows. The findings suggest that a drug that can block this “survival protein” might on its ...

Recommended for you

Two expats die of MERS in Saudi commercial hub

21 hours ago

Two foreigners died of MERS in the Saudi city of Jeddah, the health ministry said Saturday, as fears rise over the spreading respiratory virus in the kingdom's commercial hub.

UAE reports 12 new cases of MERS

22 hours ago

Health authorities in the United Arab Emirates have announced 12 new cases of infection by the MERS coronavirus, but insisted the patients would be cured within two weeks.

Filipino tests negative for Middle East virus

Apr 19, 2014

A Filipino nurse who tested positive for the Middle East virus has been found free of infection in a subsequent examination after he returned home, Philippine health officials said Saturday.

User comments : 0

More news stories

Cancer stem cells linked to drug resistance

Most drugs used to treat lung, breast and pancreatic cancers also promote drug-resistance and ultimately spur tumor growth. Researchers at the University of California, San Diego School of Medicine have discovered ...

Poll: Big Bang a big question for most Americans

Few Americans question that smoking causes cancer. But they have more skepticism than confidence in global warming, the age of the Earth and evolution and have the most trouble believing a Big Bang created the universe 13.8 ...

Making graphene in your kitchen

Graphene has been touted as a wonder material—the world's thinnest substance, but super-strong. Now scientists say it is so easy to make you could produce some in your kitchen.