A phase III, randomized, controlled, open label, no profit, single-center intervention study to compare the effect of a conservative (antithyroid drugs) and an ablative approach (radioiodine or total thyroidectomy) for the treatment of hyperthyroidism in patients with Graves’ disease and moderate-to-severe and active Graves’ Orbitopathy (GO) treated with intravenous glucocorticoids (ABLAGO Study)

You may be able to join if

• 1. Patients willing and capable of giving written informed consent, which includes compliance with the requirements and restrictions listed in the consent form 2. A diagnosis of Graves’ disease based on the presence of hyperthyroidism associated with detectable anti-thyrotropic hormone (TSH) receptor autoantibodies (TRAb). Patients must be euthyroid under control on stable medical regimen and every effort will be made to maintain the euthyroid status for the entire duration of the clinical trial. 3. Duration of Graves’ disease shorter than 18 months 4. A moderate-to-severe GO, defined as the presence of at least two of the following criteria in the most affected eye: an exophthalmos ≥3 mm compared with normal values for sex and race; presence of inconstant to constant diplopia; a lid retraction ≥2 mm; active GO (see below) 5. Active GO: CAS ≥ 3 out of 7 points in the most affected eye. Taking into account severity (moderate-to-severe) and activity (CAS ≥ 3/7) of GO, patients are eligible for methylprednisolone treatment according to clinical practice. 6. Duration of GO shorter than 18 months 7. AST, ALT and CPK levels ≤ 3 times the upper value of normal range 8. Absolute neutrophil count >1000 cells/L 9. Women of childbearing potential (WOCBP, namely not in menopause or in menopause since less than two years; in all other instances women will be considered as non-WOCBP) and men who are sexually active with WOCBP must use any contraceptive method with a failure rate of less than 1% per year (as indicated in Appendix) for at least 6 and 7,5 months, respectively, after the last dose of the investigational drug (see also 2014_09_HMA_CTFG_Contraception.pdf, namely the “2014 CTFG Recommendations related to contraception and pregnancy testing in clinical trials”) 10. Male and female patients of age 18-75 years