Control of Graves’ hyperthyroidism with very long-term methimazole treatment: a clinical trial
Abstract Background Long-term antithyroid drug therapy has become one of the options for treatment of Graves’ hyperthyroidism. The aim of this study was to compare thyroid status in those who discontinued methimazole (MMI) treatment after 12.8 years with those who continued MMI as long as 24 years....
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-01-01
|
| Series: | BMC Endocrine Disorders |
| Online Access: | https://doi.org/10.1186/s12902-020-00670-w |
| _version_ | 1818821795496591360 |
|---|---|
| author | Fereidoun Azizi Hengameh Abdi Atieh Amouzegar |
| author_facet | Fereidoun Azizi Hengameh Abdi Atieh Amouzegar |
| author_sort | Fereidoun Azizi |
| collection | DOAJ |
| description | Abstract Background Long-term antithyroid drug therapy has become one of the options for treatment of Graves’ hyperthyroidism. The aim of this study was to compare thyroid status in those who discontinued methimazole (MMI) treatment after 12.8 years with those who continued MMI as long as 24 years. Methods Fifty nine patients with Graves’ disease on long-term MMI for 14.2 ± 2.9 years were recruited; 32 patients (54%) decided to discontinue MMI and 27 (46%) preferred additional years of MMI treatment. All patients were followed for a mean of 6 additional years. Results Of 27 patients who continued MMI up to 24 years, suppressed serum thyrotropin (TSH) was not observed in any patient after the seventh year of treatment. Serum free thyroxine, triiodothyronine, TSH and TSH receptor antibody concentrations remained normal up to the length of the study. Mean daily dose of MMI to maintain TSH in the reference range decreased gradually and reached to 2.8 ± 1.7 mg by 24 years of MMI treatment. No adverse reaction related to MMI occured during additional years of therapy. In 32 patients who discontinued MMI, hyperthyroidism relapsed in 6 patients (19%), one left follow-up and 25 (78%) remained euthyroid during the study. Conclusions Long-term low dose MMI treatment may be a lifelong effective and safe therapeutic modality in patients with Graves’ hyperthyroidism for prevention of relapse, if studies from other centers confirm findings of this research. Trial registration IRCT201009224794N1, 2010-10-25. Retrospectively registered. https://www.irct.ir/trial/5143 . |
| first_indexed | 2024-12-18T23:13:52Z |
| format | Article |
| id | doaj.art-fefa68269c64497b82c84dd961ef0b0d |
| institution | Directory Open Access Journal |
| issn | 1472-6823 |
| language | English |
| last_indexed | 2024-12-18T23:13:52Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Endocrine Disorders |
| spelling | doaj.art-fefa68269c64497b82c84dd961ef0b0d2022-12-21T20:48:17ZengBMCBMC Endocrine Disorders1472-68232021-01-012111710.1186/s12902-020-00670-wControl of Graves’ hyperthyroidism with very long-term methimazole treatment: a clinical trialFereidoun Azizi0Hengameh Abdi1Atieh Amouzegar2Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesEndocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesEndocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesAbstract Background Long-term antithyroid drug therapy has become one of the options for treatment of Graves’ hyperthyroidism. The aim of this study was to compare thyroid status in those who discontinued methimazole (MMI) treatment after 12.8 years with those who continued MMI as long as 24 years. Methods Fifty nine patients with Graves’ disease on long-term MMI for 14.2 ± 2.9 years were recruited; 32 patients (54%) decided to discontinue MMI and 27 (46%) preferred additional years of MMI treatment. All patients were followed for a mean of 6 additional years. Results Of 27 patients who continued MMI up to 24 years, suppressed serum thyrotropin (TSH) was not observed in any patient after the seventh year of treatment. Serum free thyroxine, triiodothyronine, TSH and TSH receptor antibody concentrations remained normal up to the length of the study. Mean daily dose of MMI to maintain TSH in the reference range decreased gradually and reached to 2.8 ± 1.7 mg by 24 years of MMI treatment. No adverse reaction related to MMI occured during additional years of therapy. In 32 patients who discontinued MMI, hyperthyroidism relapsed in 6 patients (19%), one left follow-up and 25 (78%) remained euthyroid during the study. Conclusions Long-term low dose MMI treatment may be a lifelong effective and safe therapeutic modality in patients with Graves’ hyperthyroidism for prevention of relapse, if studies from other centers confirm findings of this research. Trial registration IRCT201009224794N1, 2010-10-25. Retrospectively registered. https://www.irct.ir/trial/5143 .https://doi.org/10.1186/s12902-020-00670-w |
| spellingShingle | Fereidoun Azizi Hengameh Abdi Atieh Amouzegar Control of Graves’ hyperthyroidism with very long-term methimazole treatment: a clinical trial BMC Endocrine Disorders |
| title | Control of Graves’ hyperthyroidism with very long-term methimazole treatment: a clinical trial |
| title_full | Control of Graves’ hyperthyroidism with very long-term methimazole treatment: a clinical trial |
| title_fullStr | Control of Graves’ hyperthyroidism with very long-term methimazole treatment: a clinical trial |
| title_full_unstemmed | Control of Graves’ hyperthyroidism with very long-term methimazole treatment: a clinical trial |
| title_short | Control of Graves’ hyperthyroidism with very long-term methimazole treatment: a clinical trial |
| title_sort | control of graves hyperthyroidism with very long term methimazole treatment a clinical trial |
| url | https://doi.org/10.1186/s12902-020-00670-w |
| work_keys_str_mv | AT fereidounazizi controlofgraveshyperthyroidismwithverylongtermmethimazoletreatmentaclinicaltrial AT hengamehabdi controlofgraveshyperthyroidismwithverylongtermmethimazoletreatmentaclinicaltrial AT atiehamouzegar controlofgraveshyperthyroidismwithverylongtermmethimazoletreatmentaclinicaltrial |