Literature DB >> 15853819

The effect of combination therapy with propylthiouracil and cholestyramine in the treatment of Graves' hyperthyroidism.

Wen-Chin Tsai1, Dee Pei, Tso-Fu Wang, Du-An Wu, Jer-Chuan Li, Cheng Lian Wei, Chien-Hsing Lee, Sheng-Pyng Chen, Shi-Wen Kuo.   

Abstract

OBJECTIVE: The study aims to evaluate the efficacy of combination therapy with propylthiouracil (PTU) and cholestyramine in the treatment of Graves' hyperthyroidism.
BACKGROUND: Thyroxine (T4) is metabolized mainly in the liver by conjugation to glucuronides and sulphates that enter the enterohepatic circulation. Thyrotoxic patients have an abnormal increase in thyroid hormone in their enterohepatic circulation. Previous studies on combination therapy with methimazole and cholestyramine for Graves' hyperthyroidism have shown it to be an effective adjunctive treatment. In this study, we examined the efficacy of combination therapy with PTU and cholestyramine in the treatment of Graves' hyperthyroidism.
METHODS: Thirty patients with newly diagnosed Graves' hyperthyroidism were randomly divided into two groups: group I (n = 15) received PTU 100 mg twice a day, propranolol 40 mg twice a day and cholestyramine 4 g twice a day for 4 weeks; group II (n = 15) received PTU 100 mg twice a day and propranolol 40 mg twice a day for 4 weeks. The therapeutic efficacy was determined by serum total triiodothyronine (TT3), free thyroxine (FT4) and TRAb levels at baseline, and at the end of 2 and 4 weeks during the study period.
RESULTS: There was no significant difference in baseline thyroid function parameters. At the end of 2 and 4 weeks of the study period, serum TT3 and FT4 levels of group I were significantly lower than those of group II. No significant differences in the TRAb level were found between the two groups.
CONCLUSION: Cholestyramine contributed to a more rapid and complete decline in thyroid hormone levels in patients with Graves' hyperthyroidism. It was thus proved to be an effective and well-tolerated adjunctive therapy.

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Year:  2005        PMID: 15853819     DOI: 10.1111/j.1365-2265.2005.02249.x

Source DB:  PubMed          Journal:  Clin Endocrinol (Oxf)        ISSN: 0300-0664            Impact factor:   3.478


  19 in total

1.  Low doses of cholestyramine in the treatment of hyperthyroidism.

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Review 2.  Diagnosis and management of Graves disease: a global overview.

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3.  Cholestyramine as monotherapy for Graves' hyperthyroidism.

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4.  Endocrine and metabolic emergencies: thyroid storm.

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5.  Resistant type 2 amiodarone-induced thyrotoxicosis responsive to cholestyramine as an adjunctive therapy.

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Review 6.  Clinical Review and Update on the Management of Thyroid Storm.

Authors:  Reuben De Almeida; Sean McCalmon; Peminda K Cabandugama
Journal:  Mo Med       Date:  2022 Jul-Aug

7.  Current and emerging treatment options for Graves' hyperthyroidism.

Authors:  Prakash Abraham; Shamasunder Acharya
Journal:  Ther Clin Risk Manag       Date:  2010-02-02       Impact factor: 2.423

Review 8.  Antithyroid drug regimen for treating Graves' hyperthyroidism.

Authors:  Prakash Abraham; Alison Avenell; Susan C McGeoch; Louise F Clark; John S Bevan
Journal:  Cochrane Database Syst Rev       Date:  2010-01-20

9.  Surviving the storm: two cases of thyroid storm successfully treated with plasmapheresis.

Authors:  Aubrey Carhill; Absalon Gutierrez; Ronak Lakhia; Ramaswami Nalini
Journal:  BMJ Case Rep       Date:  2012-10-19

Review 10.  Role of Cholestyramine in Refractory Hyperthyroidism: A Case Report and Literature Review.

Authors:  Khaled A Alswat
Journal:  Am J Case Rep       Date:  2015-07-24
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