Roberto Negro1, Laszlo Hegedüs2, Roberto Attanasio3, Enrico Papini4, Kristian H Winther2. 1. Division of Endocrinology, V. Fazzi Hospital, Lecce, Italy. 2. Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark. 3. Endocrine Unit, IRCCS Istituto Galeazzi, Milan, Italy. 4. Department of Endocrinology and Metabolism, Ospedale Regina Apostolorum, Rome, Italy.
Abstract
OBJECTIVE: Selenium (Se) supplementation has been suggested in the treatment of Graves' disease (GD). We sought to investigate Se prescription patterns for GD across European countries. METHODS: Members of the European Thyroid Association were invited to participate in an online survey investigating the use of Se in GD either without or with orbitopathy (GO). Of 872 invited members, 244 (28%) completed the survey. After exclusion of basic scientists and non-European members, 197 responses were retrieved out of clinical trials (nearly half of clinician members), of whom 61 do not use Se. Thus, 136 respondents remained for further analyses. RESULTS: Among the 136 analyzed respondents, most (64.7%) were not aware of the Se status in their populations, did not assess Se levels (78.7%), nor considered iodine status (74.3%). In GD without GO, 38.2% recommend Se supplementation ("sometimes" [27.2%], "frequently" [5.9%] or "always" [5.1%]). When GO occurs, 94.1% recommend Se supplementation ("sometimes" [39%], "frequently" [30.1%] or "always" [25%]). Of these, 60.1% recommend Se as an alternative to watchful waiting in patients with mild ocular involvement and 44.9% as an adjuvant to the established treatment modalities in patients with moderate to severe ocular involvement. CONCLUSIONS: In Graves' hyperthyroidism without GO, 38.2% of ETA (European Thyroid Association) members recommend Se supplementation. Conversely, Se is recommended by the majority of respondents in GO, both in patients with mild and moderate to severe ocular involvement. This clinical practice is partially in disagreement with current European treatment guidelines that recommend Se as a 6-month treatment in mild GO only.
OBJECTIVE: Selenium (Se) supplementation has been suggested in the treatment of Graves' disease (GD). We sought to investigate Se prescription patterns for GD across European countries. METHODS: Members of the European Thyroid Association were invited to participate in an online survey investigating the use of Se in GD either without or with orbitopathy (GO). Of 872 invited members, 244 (28%) completed the survey. After exclusion of basic scientists and non-European members, 197 responses were retrieved out of clinical trials (nearly half of clinician members), of whom 61 do not use Se. Thus, 136 respondents remained for further analyses. RESULTS: Among the 136 analyzed respondents, most (64.7%) were not aware of the Se status in their populations, did not assess Se levels (78.7%), nor considered iodine status (74.3%). In GD without GO, 38.2% recommend Se supplementation ("sometimes" [27.2%], "frequently" [5.9%] or "always" [5.1%]). When GO occurs, 94.1% recommend Se supplementation ("sometimes" [39%], "frequently" [30.1%] or "always" [25%]). Of these, 60.1% recommend Se as an alternative to watchful waiting in patients with mild ocular involvement and 44.9% as an adjuvant to the established treatment modalities in patients with moderate to severe ocular involvement. CONCLUSIONS: In Graves' hyperthyroidism without GO, 38.2% of ETA (European Thyroid Association) members recommend Se supplementation. Conversely, Se is recommended by the majority of respondents in GO, both in patients with mild and moderate to severe ocular involvement. This clinical practice is partially in disagreement with current European treatment guidelines that recommend Se as a 6-month treatment in mild GO only.
Authors: Jennifer K MacFarquhar; Danielle L Broussard; Paul Melstrom; Richard Hutchinson; Amy Wolkin; Colleen Martin; Raymond F Burk; John R Dunn; Alice L Green; Roberta Hammond; William Schaffner; Timothy F Jones Journal: Arch Intern Med Date: 2010-02-08
Authors: Claudio Marcocci; George J Kahaly; Gerasimos E Krassas; Luigi Bartalena; Mark Prummel; Matthias Stahl; Maria Antonietta Altea; Marco Nardi; Susanne Pitz; Kostas Boboridis; Paolo Sivelli; George von Arx; Maarten P Mourits; Lelio Baldeschi; Walter Bencivelli; Wilmar Wiersinga Journal: N Engl J Med Date: 2011-05-19 Impact factor: 91.245