Thyroid eye disease is traditionally treated with high dose glucocorticosteroids and surgical orbital decompression, where responses are often inadequate. This medical treatment is centred around symptom control and reduction of thyroid hormone synthesis, not immunosuppression. Rituximab is an anti-CD20 monoclonal antibody that leads to B-lymphocyte depletion, which shows some promise as an alternative therapeutic option in the treatment of thyroid eye disease. The authors review 43 cases of thyroid eye disease treated with rituximab in the medical literature. Various doses were used in the patients reviewed. In general, patients improved clinically and exhibited improvements in the clinical activity score of the disease. The overall finding is that results are variable with regard to the value of rituximab and larger studies are required to determine the long-term effectiveness of rituximab.

Rituximab in the treatment of thyroid eye disease: A review.
Ostrowski RA, Bussey MR, Shayesteh Y, Jay WM.
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Claire Howard

Salford Royal NHS Foundation Trust, Salford, UK.

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