RESUMEN
BACKGROUND: Selenium (Se) shows potential benefit in Graves' disease (GD) especially those with active Graves' ophthalmopathy(GO). OBJECTIVES: To evaluate the efficacy of Se supplementation among patients with GD and GO. METHODOLOGY: We performed a meta-analysis of trials evaluating the efficacy of Se supplementation among adult patients with GD and active GO, versus either placebo or an alternative drug, and on top of standard therapy. 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 Chi2 tests were used to assess heterogeneity.RESULTS: Only two trials were ultimately included in the analysis. Both studies totaled 197 participants with GD and non-severe GO on standard therapy, and compared Se supplementation to placebo. The only common outcomes of interest were changes in TSH receptor antibody (TRAB) and thyroid peroxidase antibody (TPOAB) titers. We found no statistically significant difference in either TRAB (95% CI,-1.38 [-3.19, 0.44], p=0.14) or TPOAB (95% CI, 36.66 [-32.56, 105.88], p=0.30) titers between Se and placebo groups on follow up.However,our analysis was limited by the small number of included studies, a small sample size, and lack of other synthesizable outcomes.CONCLUSION: This is the first meta-analysis summarizing the available data on Se supplementation in patients with GD and 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 validate these findings.