Evaluation of the Efficacy and Safety of Intravenous Methylprednisolone Pulse Therapy in Patients with Active, Moderate to Severe Thyroid Eye Disease: A Prospective Observational Study

Thyroid Eye Diseaseis an autoimmune inflammatory disorder that can cause proptosis, diplopia, and vision-threatening complications. High-dose corticosteroids are the mainstay of treatment, with weekly intravenous methylprednisolone pulses recommended by EUGOGO guidelines as first-line therapy. However, weekly protocols require frequent hospital visits and can increase healthcare burden and patient dropout rates. This study aims to evaluate the efficacy and safety of a 3-weekly IVMP pulse regimen which is, 1 g IVMP daily for 3 days as induction, followed by 500 mg IVMP every 3 weeks for 5 cycles in patients with active, moderate-to-severe TED. Outcomes will be assessed using Clinical Activity Scoreand VISA scoring at baseline and at each follow-up visit to monitor improvement in inflammation, proptosis, strabismus, and visual function. The study expects to demonstrate comparable efficacy to weekly regimens, improved patient compliance, and a favorable safety profile, potentially offering a more convenient and resource-efficient alternative for TED management.