Long-term follow-up result of antithyroid drug treatment of Graves’ hyperthyroidism in a large cohort
Objective: This study evaluated the efficacy of antithyroid drugs (ATDs) and risk factors associated with the recurrence of Graves’ hyperthyroidism using a comprehensive retrospective cohort. Methods: We included 1829 patients newly diagnosed with Graves’ hyperthyroidism, with sufficient follow-up...
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| Format: | Article |
| Language: | English |
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Bioscientifica
2023-03-01
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| Series: | European Thyroid Journal |
| Subjects: | |
| Online Access: | https://etj.bioscientifica.com/view/journals/etj/12/2/ETJ-22-0226.xml |
| _version_ | 1797867153835163648 |
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| author | Meihua Jin Ahreum Jang Chae A Kim Tae Young Kim Won Bae Kim Young Kee Shong Min Ji Jeon Won Gu Kim |
| author_facet | Meihua Jin Ahreum Jang Chae A Kim Tae Young Kim Won Bae Kim Young Kee Shong Min Ji Jeon Won Gu Kim |
| author_sort | Meihua Jin |
| collection | DOAJ |
| description | Objective: This study evaluated the efficacy of antithyroid drugs (ATDs) and risk factors associated with the recurrence of Graves’ hyperthyroidism using a comprehensive retrospective cohort.
Methods: We included 1829 patients newly diagnosed with Graves’ hyperthyroidism, with sufficient follow-up data. Clinical outcomes of the patients and risk factors associated with recurrence-free survival, including the changes in thyrotropin receptor antibody, were evaluated.
Results: The median age of the patients was 44.5 years, and 69% were female. Among the patients, 1235 had a chance to withdraw ATD after a median of 23 (interquartile range (IQR) 17.0–35.5) months of treatment. The first remission rate was 55.6% during a median of 72.7 months of follow-up. After the first recurrence, 95% of patients underwent the second course of ATD treatment for a median of 21 .1 (IQR 14.8–31.7) months, and the remission rate was 54.1%. During a median of 67 months of follow-up, 7.7% of patients underwent surgery, and 10.5% underwent radioac tive iodine therapy. Approximately 30% were still on ATD therapy for recurrent disease or prolonged lowdose maintenance. Younger age (<45 years), male sex, and fluctua ting or smoldering of TRAb levels were independent risk factors of the first recurrenc e after ATD treatment.
Conclusions: ATD treatment is an acceptable option for the initial treatment of Graves’ hyperthyroidism as well as for recurrent disease. The optimal treatment period for ATD treatment needs to be determined using the individual risk factors of recurrence. |
| first_indexed | 2024-04-09T23:35:46Z |
| format | Article |
| id | doaj.art-00446fd1eb774bedbd54e4c86145df20 |
| institution | Directory Open Access Journal |
| issn | 2235-0802 |
| language | English |
| last_indexed | 2024-04-09T23:35:46Z |
| publishDate | 2023-03-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | European Thyroid Journal |
| spelling | doaj.art-00446fd1eb774bedbd54e4c86145df202023-03-20T07:48:54ZengBioscientificaEuropean Thyroid Journal2235-08022023-03-01122111https://doi.org/10.1530/ETJ-22-0226Long-term follow-up result of antithyroid drug treatment of Graves’ hyperthyroidism in a large cohortMeihua Jin0Ahreum Jang1Chae A Kim2Tae Young Kim3Won Bae Kim4Young Kee Shong5Min Ji Jeon6Won Gu Kim7Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Endocrinology and Metabolism, Department Internal Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine and School of Medicine, Seoul, Republic of Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDivision of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDivision of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDivision of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDivision of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDivision of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaObjective: This study evaluated the efficacy of antithyroid drugs (ATDs) and risk factors associated with the recurrence of Graves’ hyperthyroidism using a comprehensive retrospective cohort. Methods: We included 1829 patients newly diagnosed with Graves’ hyperthyroidism, with sufficient follow-up data. Clinical outcomes of the patients and risk factors associated with recurrence-free survival, including the changes in thyrotropin receptor antibody, were evaluated. Results: The median age of the patients was 44.5 years, and 69% were female. Among the patients, 1235 had a chance to withdraw ATD after a median of 23 (interquartile range (IQR) 17.0–35.5) months of treatment. The first remission rate was 55.6% during a median of 72.7 months of follow-up. After the first recurrence, 95% of patients underwent the second course of ATD treatment for a median of 21 .1 (IQR 14.8–31.7) months, and the remission rate was 54.1%. During a median of 67 months of follow-up, 7.7% of patients underwent surgery, and 10.5% underwent radioac tive iodine therapy. Approximately 30% were still on ATD therapy for recurrent disease or prolonged lowdose maintenance. Younger age (<45 years), male sex, and fluctua ting or smoldering of TRAb levels were independent risk factors of the first recurrenc e after ATD treatment. Conclusions: ATD treatment is an acceptable option for the initial treatment of Graves’ hyperthyroidism as well as for recurrent disease. The optimal treatment period for ATD treatment needs to be determined using the individual risk factors of recurrence.https://etj.bioscientifica.com/view/journals/etj/12/2/ETJ-22-0226.xmlgraves’ hyperthyroidismantithyroid drugthyrotropin receptor antibodyremission |
| spellingShingle | Meihua Jin Ahreum Jang Chae A Kim Tae Young Kim Won Bae Kim Young Kee Shong Min Ji Jeon Won Gu Kim Long-term follow-up result of antithyroid drug treatment of Graves’ hyperthyroidism in a large cohort European Thyroid Journal graves’ hyperthyroidism antithyroid drug thyrotropin receptor antibody remission |
| title | Long-term follow-up result of antithyroid drug treatment of Graves’ hyperthyroidism in a large cohort |
| title_full | Long-term follow-up result of antithyroid drug treatment of Graves’ hyperthyroidism in a large cohort |
| title_fullStr | Long-term follow-up result of antithyroid drug treatment of Graves’ hyperthyroidism in a large cohort |
| title_full_unstemmed | Long-term follow-up result of antithyroid drug treatment of Graves’ hyperthyroidism in a large cohort |
| title_short | Long-term follow-up result of antithyroid drug treatment of Graves’ hyperthyroidism in a large cohort |
| title_sort | long term follow up result of antithyroid drug treatment of graves hyperthyroidism in a large cohort |
| topic | graves’ hyperthyroidism antithyroid drug thyrotropin receptor antibody remission |
| url | https://etj.bioscientifica.com/view/journals/etj/12/2/ETJ-22-0226.xml |
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