So Young Park1,2, Bo Hyun Kim3, Mijin Kim3, A Ram Hong4, Jun Park1, Hyunju Park1, Min Sun Choi1, Tae Hyuk Kim1, Sun Wook Kim1, Ho-Cheol Kang5, Jae Hoon Chung6. 1. Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 2. Division of Endocrinology, Department of Medicine, Korea University Ansan Hospital, Ansan, Korea. 3. Division of Endocrinology and Metabolism, Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea. 4. Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea. 5. Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea. drkang@chonnam.ac.kr. 6. Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jaeh.chung@samsung.com.
Abstract
PURPOSE: Current literature suggests 12-18 months of antithyroid drug (ATD) treatment for patients with Graves' disease, but the risk of relapse is high. Although some studies reported better outcomes of long-term ATD treatment, recent data that suggest the optimal treatment duration are limited. METHODS: We performed a multicenter retrospective cohort study of 908 patients newly diagnosed with Graves' disease between 2006 and 2013. The relapse rate according to ATD treatment duration was analyzed. RESULTS: After initial ATD treatment, 338 patients (37.2%) had relapsed. The relapse rate according to ATD treatment duration was 42.4% at 1 year, 38.5% at 2 years, 33.8% at 3 years, 31.7% at 4 years, 30.2% at 5 years, 27.8% at 6 years, and 19.1% at more than 6 years, respectively, demonstrating a significant decreasing trend (p = 0.003). In a multivariable Cox regression analysis, ATD treatment duration was an independent risk factor for relapse (p = 0.043). CONCLUSIONS: The longer that ATD therapy is used, the lower the relapse rate is in patients with Graves' disease. Long-term ATD treatment may be considered in Graves' patients who do not show complications or an economic burden from hyperthyroidism.
PURPOSE: Current literature suggests 12-18 months of antithyroid drug (ATD) treatment for patients with Graves' disease, but the risk of relapse is high. Although some studies reported better outcomes of long-term ATD treatment, recent data that suggest the optimal treatment duration are limited. METHODS: We performed a multicenter retrospective cohort study of 908 patients newly diagnosed with Graves' disease between 2006 and 2013. The relapse rate according to ATD treatment duration was analyzed. RESULTS: After initial ATD treatment, 338 patients (37.2%) had relapsed. The relapse rate according to ATD treatment duration was 42.4% at 1 year, 38.5% at 2 years, 33.8% at 3 years, 31.7% at 4 years, 30.2% at 5 years, 27.8% at 6 years, and 19.1% at more than 6 years, respectively, demonstrating a significant decreasing trend (p = 0.003). In a multivariable Cox regression analysis, ATD treatment duration was an independent risk factor for relapse (p = 0.043). CONCLUSIONS: The longer that ATD therapy is used, the lower the relapse rate is in patients with Graves' disease. Long-term ATD treatment may be considered in Graves' patients who do not show complications or an economic burden from hyperthyroidism.
Authors: Onyebuchi E Okosieme; Peter N Taylor; Carol Evans; Dan Thayer; Aaron Chai; Ishrat Khan; Mohd S Draman; Brian Tennant; John Geen; Adrian Sayers; Robert French; John H Lazarus; Lakdasa D Premawardhana; Colin M Dayan Journal: Lancet Diabetes Endocrinol Date: 2019-02-28 Impact factor: 32.069
Authors: Douglas S Ross; Henry B Burch; David S Cooper; M Carol Greenlee; Peter Laurberg; Ana Luiza Maia; Scott A Rivkees; Mary Samuels; Julie Ann Sosa; Marius N Stan; Martin A Walter Journal: Thyroid Date: 2016-10 Impact factor: 6.568