Endocrine Abstracts

Background: Selenium (Se), a trace mineral with anti-oxidative properties, has been proposed to be potentially beneficial in patients with Graves’ disease (GD), especially those with active Graves’ ophthalmopathy (GO).

Methods: Trials evaluating the efficacy of Se among non-pregnant adult GD patients with active GO, versus either placebo or an alternative drug, and on top of standard therapy, were included. A literature search was performed by two independent authors with eligible studies undergoing a validity screen. Data extraction of selected studies was performed using a data extraction form, with subsequent statistical analysis using RevMan 5.1 software. Results were presented as mean differences, standard errors, and 95% confidence intervals, and graphically presented as forest plots. Estimates were calculated using the inverse variance method for continuous variables and pooled using the fixed effects model. I² and χ² tests were used to assess heterogeneity.

Results: Fourteen studies were initially retrieved, but only two trials were ultimately included in the analysis. Both had good methodological quality and totalled 197 GD patients with active, non-severe GO. The only common outcomes of interest were changes in TRAB and TPOAB titers. We found no statistically significant difference in both TRAB (95% CI, −1.38 (−3.19, 0.44), P=0.14) and TPOAB (95% CI, 36.66 (−32.56, 105.88), P=0.3) titers on follow-up among patients given Se as compared to placebo. No significant heterogeneity was observed in either analysis (TRAB, I²=36%; TPOAB, I²=0%). However, our study was limited by the small number of studies, a small sample size, and lack of other synthesizable outcomes.

Conclusion: This is the first meta-analysis on the efficacy of Se in GD patients with active, non-severe GO. We found no statistically significant differences in both TRAB and TPOAB titers between Se and placebo groups. We recommend larger studies to further validate these findings.