Statin therapy considered for thyroid eye disease

Issue: May 10, 2016

VANCOUVER, British Columbia — Statins show promise as a low-risk disease-modifying agent for treating thyroid eye disease, for which smoking is seen as the only modifiable risk factor.

A hyperosmotic shift of fluid into orbital tissue is associated with thyroid eye disease, and the resultant inflammatory state can last for 1 to 2 years, Andrew L. Reynolds, MD, said at the American Association for Pediatric Ophthalmology and Strabismus meeting.

Andrew L. Reynolds

Because of their anti-inflammatory effects and effects against some agents that contribute to thyroid eye disease, for example, interleukin-6 and tumor necrosis factor-alpha, statins are a “pretty attractive target for thyroid eye disease,” Reynolds said.

Reynolds and colleagues at Kellogg Eye Center, Ann Arbor, Michigan, conducted a retrospective review of 30 patients with both thyroid eye disease and restrictive strabismus who were either taking statins (12 patients) or not taking statins (18 patients).

“We looked at a whole host of things,” Reynolds said of the analysis that compared the two groups for smoking status, previous radioactive iodine therapy, previous thyroidectomy, number of decompressions, motility restriction, prism diopters of strabismus in all gazes, total number of strabismus surgeries, total millimeters of strabismus surgery and total number of muscles involved as seen radiographically.

Demographically, the “deck was stacked” against the patients in the statin group, Reynolds said, in that these patients had more characteristics that put them at risk for thyroid eye disease. They tended to be older, more were smokers (both former and current), more were male, more had a history of radioactive iodine therapy, and fewer had undergone thyroidectomy than in the non-statin group. Even so, these patients tended to have fewer decompressions, less restriction, fewer strabismus surgeries and fewer muscles involved, Reynolds said.

“Oral statin therapy may provide a relatively novel, safe treatment modality to prevent or treat the orbital complications of thyroid eye,” he said. – by Patricia Nale, ELS

Reference: Reynolds AL. The effect of oral statin therapy on strabismus in patients with thyroid eye disease. Paper 5 presented at: American Association for Pediatric Ophthalmology and Strabismus 42nd annual meeting; April 6-10, 2016; Vancouver, British Columbia.

Disclosure: Reynolds reports no relevant financial disclosures.