Antithyroid Drug Treatment in Graves’ Disease

Graves’ disease is associated with thyrotropin (TSH) receptor stimulating antibody, for which there is no therapeutic agent. This disease is currently treated through inhibition of thyroid hormone synthesis or destruction of the thyroid gland. Recurrence after antithyroid drug (ATD) treatment is com...

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Main Author: Jae Hoon Chung
Format: Article
Language:English
Published: Korean Endocrine Society 2021-06-01
Series:Endocrinology and Metabolism
Subjects:
Online Access:http://www.e-enm.org/upload/pdf/enm-2021-1070.pdf
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author Jae Hoon Chung
author_facet Jae Hoon Chung
author_sort Jae Hoon Chung
collection DOAJ
description Graves’ disease is associated with thyrotropin (TSH) receptor stimulating antibody, for which there is no therapeutic agent. This disease is currently treated through inhibition of thyroid hormone synthesis or destruction of the thyroid gland. Recurrence after antithyroid drug (ATD) treatment is common. Recent studies have shown that the longer is the duration of use of ATD, the higher is the remission rate. Considering the relationship between clinical outcomes and iodine intake, recurrence of Graves’ disease is more common in iodine-deficient areas than in iodine-sufficient areas. Iodine restriction in an iodine-excessive area does not improve the effectiveness of ATD or increase remission rates. Recently, Danish and Korean nationwide studies noted significantly higher prevalence of birth defects in newborns exposed to ATD during the first trimester compared to that of those who did not have such exposure. The prevalence of birth defects was lowest when propylthiouracil (PTU) was used and decreased by only 0.15% when methimazole was changed to PTU in the first trimester. Therefore, it is best not to use ATD in the first trimester or to change to PTU before pregnancy.
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spelling doaj.art-d39d6ca02b4f485eb6b95c8e560efd0d2022-12-21T23:40:34ZengKorean Endocrine SocietyEndocrinology and Metabolism2093-596X2093-59782021-06-0136349149910.3803/EnM.2021.10702177Antithyroid Drug Treatment in Graves’ DiseaseJae Hoon Chung0Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KoreaGraves’ disease is associated with thyrotropin (TSH) receptor stimulating antibody, for which there is no therapeutic agent. This disease is currently treated through inhibition of thyroid hormone synthesis or destruction of the thyroid gland. Recurrence after antithyroid drug (ATD) treatment is common. Recent studies have shown that the longer is the duration of use of ATD, the higher is the remission rate. Considering the relationship between clinical outcomes and iodine intake, recurrence of Graves’ disease is more common in iodine-deficient areas than in iodine-sufficient areas. Iodine restriction in an iodine-excessive area does not improve the effectiveness of ATD or increase remission rates. Recently, Danish and Korean nationwide studies noted significantly higher prevalence of birth defects in newborns exposed to ATD during the first trimester compared to that of those who did not have such exposure. The prevalence of birth defects was lowest when propylthiouracil (PTU) was used and decreased by only 0.15% when methimazole was changed to PTU in the first trimester. Therefore, it is best not to use ATD in the first trimester or to change to PTU before pregnancy.http://www.e-enm.org/upload/pdf/enm-2021-1070.pdfgraves diseaseantithyroid agentsrecurrenceiodinecongenital abnormalitiespregnancy
spellingShingle Jae Hoon Chung
Antithyroid Drug Treatment in Graves’ Disease
Endocrinology and Metabolism
graves disease
antithyroid agents
recurrence
iodine
congenital abnormalities
pregnancy
title Antithyroid Drug Treatment in Graves’ Disease
title_full Antithyroid Drug Treatment in Graves’ Disease
title_fullStr Antithyroid Drug Treatment in Graves’ Disease
title_full_unstemmed Antithyroid Drug Treatment in Graves’ Disease
title_short Antithyroid Drug Treatment in Graves’ Disease
title_sort antithyroid drug treatment in graves disease
topic graves disease
antithyroid agents
recurrence
iodine
congenital abnormalities
pregnancy
url http://www.e-enm.org/upload/pdf/enm-2021-1070.pdf
work_keys_str_mv AT jaehoonchung antithyroiddrugtreatmentingravesdisease