A Conservative vs an Ablative Approach for Treatment of Hyperthyroidism in Patients With Graves' Orbitopathy

Exclusion Criteria

• •1. Optic neuropathy
• •2. Previous therapy for Graves' disease with radioiodine or thyroidectomy
• •3. Corticosteroids or other immunosuppressive treatment for GO or other reasons in the last 3 months.
• •4. Previous surgical treatment and/or radiotherapy for GO
• •5. Contraindications to GC: hypersensitivity to the active substance or to any of the excipients; uncontrolled hypertension, uncontrolled diabetes; history of peptic ulcer; urinary infections, glaucoma, systemic fungal infections, systemic infections unless appropriate therapy is employed, idiopathic thrombocytopenic purpura, cerebral edema associated with malaria.
• •6. Use of medications interfering with GC or increasing the risk of GC-related adverse events (see prohibited therapies)
• •7. Acute or chronic liver disease
• •8. Contraindications to ATD: hypersensitivity to the active substance or to any of the excipients; breastfeeding
• •9. Women of childbearing potential (WOCBP, namely not in menopause or in menopause since less than two years; in all other instances women will be considered as non-WOCBP) and men who are sexually active with WOCBP must use any contraceptive method with a failure rate of less than 1% per year (as indicated in Appendix) for at least 6 and 7,5 months, respectively, after the last dose of the investigational drug (see also 2014\_09\_HMA\_CTFG\_Contraception.pdf, namely the "2014 CTFG Reccommendtions related to contraception and pregnancy testing in clinical trials")
• •10. Contraindications of any kind to perform thyroidectomy
• •11. Mental illness that prevent patients from comprehensive, written informed consent