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Abstract：
BACKGROUND: Graves\' ophthalmopathy is a complex autoimmune disorder that can significantly affect quality of life (QoL), vision and physical appearance. Recently, a deeper understanding of the underlying pathogenesis has led to the development of novel treatment options.
OBJECTIVE: The purpose of this review is to explore the current literature on conventional and novel treatment modalities and to evaluate which interventions provide the most favourable psychological and clinical outcomes in patients with moderate to severe, active Grave\'s ophthalmopathy. For example, QoL is an important psychosocial outcome of disease management. However, available literature demonstrates that not all clinically effective treatment options improve patients\' QoL.
METHODS: A systematic literature review was conducted to assess the clinical and psychosocial outcomes of different therapies for Graves\' ophthalmopathy. An extensive database search of Ovid Medline, Ovid Embase and Cochrane Central Register of Controlled Trials was conducted. Studies generated were reviewed and the relevant selected data were retrieved and analysed.
RESULTS: Results showed intravenous steroids, rituximab (RTX), tocilizumab and teprotumumab were all significantly effective in improving Clinical Activity Scores. Orbital radiotherapy showed a slight improvement in proptosis and diplopia. All interventions were safe with few serious adverse events being reported across all studies. All treatment modalities demonstrated beneficial improvements in both components of the Graves\' Ophthalmopathy-QoL (QoL) questionnaire, apart from orbital radiotherapy which only demonstrated improvements in the visual functioning subscale. Teprotumumab was identified to be the most effective intervention for improving both clinical and psychosocial outcomes. However, further research needs to be conducted to evaluate its side effect profile and cost-effectiveness. Nonetheless, with time it has the potential to be a first-line treatment option in the management of active moderate to severe Graves\' ophthalmopathy.
OBJECTIVE: The purpose of this review is to explore the current literature on conventional and novel treatment modalities and to evaluate which interventions provide the most favourable psychological and clinical outcomes in patients with moderate to severe, active Grave\'s ophthalmopathy. For example, QoL is an important psychosocial outcome of disease management. However, available literature demonstrates that not all clinically effective treatment options improve patients\' QoL.
METHODS: A systematic literature review was conducted to assess the clinical and psychosocial outcomes of different therapies for Graves\' ophthalmopathy. An extensive database search of Ovid Medline, Ovid Embase and Cochrane Central Register of Controlled Trials was conducted. Studies generated were reviewed and the relevant selected data were retrieved and analysed.
RESULTS: Results showed intravenous steroids, rituximab (RTX), tocilizumab and teprotumumab were all significantly effective in improving Clinical Activity Scores. Orbital radiotherapy showed a slight improvement in proptosis and diplopia. All interventions were safe with few serious adverse events being reported across all studies. All treatment modalities demonstrated beneficial improvements in both components of the Graves\' Ophthalmopathy-QoL (QoL) questionnaire, apart from orbital radiotherapy which only demonstrated improvements in the visual functioning subscale. Teprotumumab was identified to be the most effective intervention for improving both clinical and psychosocial outcomes. However, further research needs to be conducted to evaluate its side effect profile and cost-effectiveness. Nonetheless, with time it has the potential to be a first-line treatment option in the management of active moderate to severe Graves\' ophthalmopathy.
摘要：
背景：Graves眼病是一种复杂的自身免疫性疾病，可以显着影响生活质量（QoL），视觉和物理外观。最近,对潜在发病机制的更深入了解导致了新的治疗方案的发展。
目的：本综述的目的是探讨目前关于常规和新型治疗方式的文献，并评估哪些干预措施在中重度患者中提供最有利的心理和临床结局。活动性Grave眼病.例如,QoL是疾病管理的重要心理社会结果。然而,现有文献表明，并非所有临床有效的治疗方案都能改善患者的生活质量。
方法：进行了系统的文献综述，以评估Graves眼病不同治疗方法的临床和社会心理结果。对OvidMedline进行了广泛的数据库搜索，进行了OvidEmbase和Cochrane中央对照试验注册。审查产生的研究，并检索和分析相关的选定数据。
结果：结果显示静脉注射类固醇，利妥昔单抗（RTX），托珠单抗和teprotumumab均可显著提高临床活性评分.眼眶放疗显示眼球突出和复视略有改善。所有干预措施都是安全的，所有研究报告的严重不良事件很少。所有治疗模式均显示Graves眼病-QoL（QoL）问卷的两个组成部分均有有益改善，除了眼眶放射疗法仅显示视觉功能亚量表的改善。Teprotumumab被认为是改善临床和社会心理结果的最有效的干预措施。然而,需要进行进一步的研究以评估其副作用和成本效益。尽管如此，随着时间的推移,它有可能成为治疗活动性中度至重度Graves眼病的一线治疗选择.
目的：本综述的目的是探讨目前关于常规和新型治疗方式的文献，并评估哪些干预措施在中重度患者中提供最有利的心理和临床结局。活动性Grave眼病.例如,QoL是疾病管理的重要心理社会结果。然而,现有文献表明，并非所有临床有效的治疗方案都能改善患者的生活质量。
方法：进行了系统的文献综述，以评估Graves眼病不同治疗方法的临床和社会心理结果。对OvidMedline进行了广泛的数据库搜索，进行了OvidEmbase和Cochrane中央对照试验注册。审查产生的研究，并检索和分析相关的选定数据。
结果：结果显示静脉注射类固醇，利妥昔单抗（RTX），托珠单抗和teprotumumab均可显著提高临床活性评分.眼眶放疗显示眼球突出和复视略有改善。所有干预措施都是安全的，所有研究报告的严重不良事件很少。所有治疗模式均显示Graves眼病-QoL（QoL）问卷的两个组成部分均有有益改善，除了眼眶放射疗法仅显示视觉功能亚量表的改善。Teprotumumab被认为是改善临床和社会心理结果的最有效的干预措施。然而,需要进行进一步的研究以评估其副作用和成本效益。尽管如此，随着时间的推移,它有可能成为治疗活动性中度至重度Graves眼病的一线治疗选择.
