Long-term carbimazole pretreatment reduces the efficacy of radioiodine therapy
Introduction: Data from several studies suggest that pretreatment with antithyroid drugs (ATD) before 131 I increases the risk of treatment failure. This effect has been demonstrated more consistently with propylthiouracil than with carbimazole (CMZ) or methimazole (MMI). Men with Graves′ disease (G...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2015-01-01
|
| Series: | Indian Journal of Endocrinology and Metabolism |
| Subjects: | |
| Online Access: | http://www.ijem.in/article.asp?issn=2230-8210;year=2015;volume=19;issue=1;spage=84;epage=88;aulast=Shivaprasad |
| _version_ | 1818254169359777792 |
|---|---|
| author | C Shivaprasad K M Prasanna Kumar |
| author_facet | C Shivaprasad K M Prasanna Kumar |
| author_sort | C Shivaprasad |
| collection | DOAJ |
| description | Introduction: Data from several studies suggest that pretreatment with antithyroid drugs (ATD) before 131 I increases the risk of treatment failure. This effect has been demonstrated more consistently with propylthiouracil than with carbimazole (CMZ) or methimazole (MMI). Men with Graves′ disease (GD) have a lower rate of remission with 131 I compared to women and the impact of long-term ATD pretreatment on the success of 131 I is unknown. The objective of our study was to compare the efficacy of fixed doses of radioiodine between patients with and without long-term CMZ pretreatment. Materials and Methods: We performed a retrospective study on 335 male patients with GD treated with 131 I from 1998 to 2008. 148 patients had been pretreated with CMZ, and the remaining 187 patients received 131 I without pretreatment. We compared the success rate of a single dose of 131 I, between patients with and without long-term CMZ pretreatment. Results: The success rate of a single dose of 131 I was significantly higher in patients without pretreatment than in patients who were pretreated with CMZ (91.4% vs. 82.3%, P = 0.01). The rate of hypothyroidism in the first 6 months after 131 I therapy was significantly higher in patients without pretreatment (55.1% vs. 44.6%, P = 0.05). There was also a trend for higher cumulative rate of hypothyroidism at last follow-up in nonpretreated patients (78.1% vs. 69.7%). Conclusion: Male patients with Graves′ hyperthyroidism pretreated with CMZ have lower efficacy with 131I therapy compared to nonpretreated patients. CMZ pretreatment given for a prolonged period reduces the efficacy of 131 I therapy. |
| first_indexed | 2024-12-12T16:51:41Z |
| format | Article |
| id | doaj.art-7c41a41eb8294b12a329d4306018d725 |
| institution | Directory Open Access Journal |
| issn | 2230-8210 2230-9500 |
| language | English |
| last_indexed | 2024-12-12T16:51:41Z |
| publishDate | 2015-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Endocrinology and Metabolism |
| spelling | doaj.art-7c41a41eb8294b12a329d4306018d7252022-12-22T00:18:21ZengWolters Kluwer Medknow PublicationsIndian Journal of Endocrinology and Metabolism2230-82102230-95002015-01-01191848810.4103/2230-8210.146865Long-term carbimazole pretreatment reduces the efficacy of radioiodine therapyC ShivaprasadK M Prasanna KumarIntroduction: Data from several studies suggest that pretreatment with antithyroid drugs (ATD) before 131 I increases the risk of treatment failure. This effect has been demonstrated more consistently with propylthiouracil than with carbimazole (CMZ) or methimazole (MMI). Men with Graves′ disease (GD) have a lower rate of remission with 131 I compared to women and the impact of long-term ATD pretreatment on the success of 131 I is unknown. The objective of our study was to compare the efficacy of fixed doses of radioiodine between patients with and without long-term CMZ pretreatment. Materials and Methods: We performed a retrospective study on 335 male patients with GD treated with 131 I from 1998 to 2008. 148 patients had been pretreated with CMZ, and the remaining 187 patients received 131 I without pretreatment. We compared the success rate of a single dose of 131 I, between patients with and without long-term CMZ pretreatment. Results: The success rate of a single dose of 131 I was significantly higher in patients without pretreatment than in patients who were pretreated with CMZ (91.4% vs. 82.3%, P = 0.01). The rate of hypothyroidism in the first 6 months after 131 I therapy was significantly higher in patients without pretreatment (55.1% vs. 44.6%, P = 0.05). There was also a trend for higher cumulative rate of hypothyroidism at last follow-up in nonpretreated patients (78.1% vs. 69.7%). Conclusion: Male patients with Graves′ hyperthyroidism pretreated with CMZ have lower efficacy with 131I therapy compared to nonpretreated patients. CMZ pretreatment given for a prolonged period reduces the efficacy of 131 I therapy.http://www.ijem.in/article.asp?issn=2230-8210;year=2015;volume=19;issue=1;spage=84;epage=88;aulast=ShivaprasadAntithyroid drugscarbimazoleGraves′ hyperthyroidismpretreatmentradioiodine |
| spellingShingle | C Shivaprasad K M Prasanna Kumar Long-term carbimazole pretreatment reduces the efficacy of radioiodine therapy Indian Journal of Endocrinology and Metabolism Antithyroid drugs carbimazole Graves′ hyperthyroidism pretreatment radioiodine |
| title | Long-term carbimazole pretreatment reduces the efficacy of radioiodine therapy |
| title_full | Long-term carbimazole pretreatment reduces the efficacy of radioiodine therapy |
| title_fullStr | Long-term carbimazole pretreatment reduces the efficacy of radioiodine therapy |
| title_full_unstemmed | Long-term carbimazole pretreatment reduces the efficacy of radioiodine therapy |
| title_short | Long-term carbimazole pretreatment reduces the efficacy of radioiodine therapy |
| title_sort | long term carbimazole pretreatment reduces the efficacy of radioiodine therapy |
| topic | Antithyroid drugs carbimazole Graves′ hyperthyroidism pretreatment radioiodine |
| url | http://www.ijem.in/article.asp?issn=2230-8210;year=2015;volume=19;issue=1;spage=84;epage=88;aulast=Shivaprasad |
| work_keys_str_mv | AT cshivaprasad longtermcarbimazolepretreatmentreducestheefficacyofradioiodinetherapy AT kmprasannakumar longtermcarbimazolepretreatmentreducestheefficacyofradioiodinetherapy |