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Selenium May Improve Graves' Orbitopathy Symptoms

Treatment tied to improved quality of life, reduced eye involvement, slower disease progression

WEDNESDAY, May 18 (HealthDay News) -- Treatment of patients with mild Graves' orbitopathy with selenium may improve quality of life, reduce ocular involvement, and slow disease progression, according to a study published in the May 19 issue of the New England Journal of Medicine.

Claudio Marcocci, M.D., from the University of Pisa in Italy, and colleagues investigated the effect of selenium and pentoxifylline on 159 patients with mild Graves' orbitopathy. Participants were randomly allocated to treatment with 100 µg selenium twice daily, 600 mg pentoxifylline twice daily, or placebo twice daily orally for six months. Patients were followed up for six months after withdrawal of treatment. Patients underwent an overall ophthalmic assessment by an ophthalmologist (blinded to the treatment assignments) and completed a Graves' orbitopathy-specific quality-of-life questionnaire to evaluate primary outcome at six months. The Clinical Activity Score and diplopia score were used to evaluate secondary outcomes.

The investigators found that, compared to placebo, treatment with selenium was correlated with a significantly improved quality of life, less eye involvement, and slower disease progression. The Clinical Activity Score decreased in all groups, but the decrease was significantly larger in the selenium group. Immunosuppressive therapy was required for two patients assigned to placebo and one assigned to pentoxifylline whose condition deteriorated. Pentoxifylline treatment was associated with frequent gastrointestinal problems, but no adverse effects were seen with selenium treatment.

"Our data indicate that selenium supplementation for six months improves the course of Graves' orbitopathy and the related impairment in quality of life," the authors write.

One author disclosed financial relationships with GlaxoSmithKline. Merck, and Novo Nordisk.

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