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The aim of the study was to investigate the use of serial measurements ofTSH-receptor autoantibodies (TRAb) with the newest available assay technology topredict the course of Graves’ Orbitopathy (GO) during the first 24months from disease onset. Serial serum samples from patients with GO (103mild/135 severe) were collected between 2007 and 2017 andretrospectively analyzed. The course of GO were classified intomild/severe 12 months after manifestation (severe: NOSPECS≥5;mild&lt;5). TRAb were measured with automated binding immunoassays(IU/l): TRAb Elecsys (Cobas, Roche), TRAb bridge assay (IMMULITE,Siemens), and a cell-based bioassay (percent of specimen to reference ratio -SRR%) (Thyretain, Quidel). Variable cut off levels of measured TRAb werecalculated at specificity of 90% from receiver operator curve (ROC)analysis for several timepoints during the course of GO. To select one:5–8 months after first GO symptoms, which is the timepoint for usualreferals for treatment mild course could be predicted at cut offs of 1.5IU/l (Elecsys), 0.8 IU/l (Immulite) and 402% SRR(Thyretain) and the risc of severe course has to be anticipated if TRAb areabove 11.6 IU/l (Elecsys), 6.5 IU/l (Thyretain), and714% SRR (Thyretain). The Thyretain bioassay showed the highestdiagnostic sensitivity (using the commercial cut off’s) over the entirefollow up period. TRAb measurements during the 24-month follow up of GO provideadded value to the GO clinical activity and severity scores and should be usedespecially in the event of an unclear decision-taking situation with regard totherapy.

hormone and metabolic research

Predicting the Course of Graves’ Orbitopathy Using Serially Measured TSH-Receptor Autoantibodies by Automated Binding Immunoassays and the Functional Bioassay