Intravenous methylprednisolone (IVMP) pulse therapy is the first-line treatment for active moderate-to-severe thyroid eye disease (TED). However, systemic corticosteroids may affect blood pressure, glucose metabolism, and liver enzymes, requiring clinical monitoring. To evaluate changes in blood pressure, random blood glucose, and serum transaminase levels in TED patients receiving IVMP pulse therapy. A prospective cohort study was conducted on 30 TED patients treated with IVMP according to the EuGOGO protocol at the Eye Clinic of Dr. Saiful Anwar General Hospital, Malang, from January 2023 to December 2024. Systolic blood pressure (SBP), diastolic blood pressure (DBP), random blood glucose (RBG), and serum transaminases (SGOT and SGPT) were measured at baseline, after the first cycle (500 mg weekly for 6 weeks), and after the second cycle (250 mg weekly for 6 weeks). Data were analyzed using the Wilcoxon test, effect size (r), and correlation analysis. SBP increased significantly after the second cycle of IVMP therapy (p = 0.027), while DBP showed no significant change. RBG significantly increased after both the first (p = 0.000, r = 0.717) and second cycles (p = 0.000, r = 0.868), representing the strongest physiological effect. SGOT and SGPT levels fluctuated without significant changes. All parameters remained within normal clinical limits, and no serious adverse events were observed. IVMP pulse therapy in TED patients significantly increases RBG and SBP, while DBP and serum transaminases remain stable. Despite these changes, all values remain within normal ranges. Careful patient selection and monitoring are important to ensure treatment safety.
