Thyroid Eye Disease Clinical Trial
Official title:
An Open Label Trial of Celecoxib in the Treatment of Mild Thyroid Eye Disease
Thyroid eye disease (TED) is an autoimmune disorder in which the immune system attacks
orbital tissues, resulting in characteristic changes in eyelid position, globe position in
the orbit, extraocular muscle balance, and optic nerve function. TED is a potentially
blinding disease, and current treatments largely consist of nonspecific reduction of
inflammation using corticosteroids or radiation therapy. Regardless of treatment, once TED
progresses from its inflammatory phase to a more fibrotic, resolution phase, the orbital
changes become fixed and can be modified only by surgery.
The investigators propose to treat a cohort of patients with active TED using a selective
COX-2 inhibitor, celecoxib, and to compare these patients to an observational control group.
The investigators hypothesize that celecoxib will reduce the severity of disease and/or
prevent progression to proptosis, diplopia, and corneal exposure or compressive optic
neuropathy.
The investigators intend to use celecoxib, a non-steroidal anti-inflammatory drug approved by the Food and Drug Administration (FDA) for the treatment of pain, osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis, as a treatment for active TED. In vitro data have shown that transformation of orbital fibroblasts into adipocytes is mediated by cyclooxygenase-2 (COX-2), and a case report suggests that COX-2 inhibition can improve TED in the acute phase. Thus, the investigators intend to evaluate the efficacy of COX-2 inhibition in the treatment of active TED and its ability to improve both the acute inflammatory signs and more permanent fibrotic changes of quiescent disease. The investigators will enroll patients with active TED and treat them for 3 months (a characteristic period of disease activity) and compare this to standard treatments for mild active TED (observation, with over the counter interventions such as lubrication with artificial tears) to assess efficacy. ;
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