METHODS: We retrieved from 9 databases, from their foundation to March 2019, including Pubmed, the Cochrane Library, EMbase, ClinicalTrial.gov, Web of Science, CNKl, VIP database, China Biology Medicine disc, Wanfang database and collected the randomized controlled trail(RCT)of 99Tc-MDP combined with methylprednisolone for treatment of TAO. According to inclusion and exclusion criteria, two researchers retrieved the literature independently, extracted data and evaluate methodological quality. Meta analysis was performed by Review Manager 5.3 software.

RESULTS: A total of 8 RCTs were identified with 644 patients. There was significant difference in the overall clinical effective rate between 99Tc-MDP combined with methylprednisolone and methylprednisolone alone(RR=1.14, 95% CI: 1.03-1.26, P=0.01). Significant difierence was found in the effective rate of proptosis between intravenous injection of 99Tc-MDP with methyprednisone and methyprednisone only(RR=1.28, 95% CI: 1.16-1.41, P<0.00001). Meanwhile, great improvement was seen in diplopia(RR=1.64, 95% CI: 1.04-2.58, P=0.03), but there was no significant difference in disturbance of ocular dyskinesia(P=0.37).

CONCLUSION: Applying 99Tc-MDP combined with methylprednisolone is better than methylprednisolone alone for TAO with less adverse reaction, which appears to be an effective treatment for TAO.