Inclusion Criteria:  Clinical diagnosis of Graves' disease associated with active thyroid eye disease and a clinical activity score of ≥ 3 Euthyroid or with mild hypo- or hyperthyroidism defined as free thyroxine (FT4) and free triiodothyronine (FT3) levels less than 50% above or below the normal limits previous ineffective treatment (partial response, recurrence or progression of symptoms) with moderate-to-high doses of glucocorticoids (at least 4.5 g of methylprednisolone)  Exclusion Criteria:  hypersensitivity to rabbit proteins or to any product excipients active acute or chronic infections latent tuberculosis leucopenia below 3000/μl lymphopenia below 400/μl thrombocytopenia below 75000/μl coagulation disorders active malignancy and pregnancy