A Randomized Comparison of Radioiodine Doses in Graves’ Hyperthyroidism

Leslie, William D.; Ward, Linda; Salamon, Elizabeth; Ludwig, Sora; Rowe, Richard C.; Cowden, E.A.

doi:10.1210/jc.2002-020805

Cited by 167 publications

(147 citation statements)

References 20 publications

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“…Despite its efficacy, radioiodine therapy (RAIT) fails in 10-50% of cases (4). The success of RAIT is influenced by many variables, including gender, age, thyroid volume, prior use of antithyroid drugs and baseline free thyroxine (FT4) levels; however, none of these variables reliably predict the outcome after RAIT (5)(6)(7)(8)(9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

Low iodine diet does not improve the efficacy of radioiodine for the treatment of Graves’ disease

Santarosa

Orlandi

Fiorin

et al. 2015

Arch. Endocrinol. Metab.

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Objective: Consuming a low-iodine diet (LID) is a widely accepted practice before administering radioiodine ( 131 I) to evaluate and to treat thyroid disease. Although this procedure is well established for the management of patients with differentiated thyroid cancer, its use in patients with benign disease is unclear. So, we aimed to evaluate the influence of a LID on the outcome in patients with Graves' disease (GD) treated with 131 I. Subjects and methods: We evaluated 67 patients with GD who were divided into 2 groups: one group (n = 31) consumed a LID for 1-2 weeks, and the second group (n = 36) was instructed to maintain a regular diet (RD). Results: The LID group experienced a 23% decrease in urinary iodine after 1 week on the diet and a significant 42% decrease after 2 weeks on the diet. The majority (53%) of the patients in the LID group had urinary iodine levels that were consistent with deficient iodine intake. However, there was no difference in the rate of hyperthyroidism's cure between the LID and the RD groups 6 months after 131 I therapy. Furthermore, the therapeutic efficacy did not differ in patients with varying degrees of sufficient iodine intake (corresponding urinary iodine levels: < 10 μg/dL is deficient; 10-29.9 μg/dL is sufficient; and > 30 μg/dL is excessive). Conclusion:In the present study, we demonstrated that although a LID decreased urinary iodine levels, those levels corresponding with sufficient or a mild excess in iodine intake did not compromise the therapeutic efficacy of 131 I for the treatment of GD. Arch Endocrinol Metab. 2015;59(6):501-6

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Section: Introductionmentioning

confidence: 99%

Low iodine diet does not improve the efficacy of radioiodine for the treatment of Graves’ disease

Santarosa

Orlandi

Fiorin

et al. 2015

Arch. Endocrinol. Metab.

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“…15 The failure rate of RAI treatment is less than 20%; therefore, this form of therapy should be considered initially and discussed with GD patients. Antithyroid drugs should not be given immediately before or after RAI as this may increase treatment failure rate.…”

Section: Radioactive Iodinementioning

confidence: 99%

Medical Management of Hyperthyroidism

Ajjan¹,

Weetman²

2007

US Endocrinology

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“…There is still no consensus regarding the most appropriate approach for treating Graves' hyperthyroidism with radioiodine (11,12,13,14,15,16,17). Administered radioactive iodine (RAI) activities can be either fixed (for ablation) or adjusted for different parameters such as thyroid mass, radioiodine effective period and thyroid uptake values (for either ablation or restoration of euthyroidism) (18,19).…”

Section: Introductionmentioning

confidence: 99%

Quality of life, clinical outcomes and safety of early prophylactic levothyroxine administration in patients with Graves' hyperthyroidism undergoing radioiodine therapy: a randomized controlled study

Taïeb¹,

Bournaud

Eberlé

et al. 2016

European Journal of Endocrinology

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Objective: While radioiodine therapy is commonly used for treating Graves' disease, a prolonged and clinical hypothyroidism may result in disabling symptoms leading to deterioration of quality of life (QoL) of patients. Introducing levothyroxine (LT 4 ) treatment in the early post-therapeutic period may be an interesting approach to limit this phenomenon. Methods: A multicenter, prospective, open-label randomized controlled trial enrolled 94 patients with Graves' hyperthyroidism randomly assigned to the experimental group (nZ46) (group A: early prophylactic LT 4 treatment) or the control group (nZ48) (group B: standard follow-up). The primary endpoint was the 6-month QoL. The secondary endpoints were other QoL scores such as Graves' ophthalmopathy (GO) outcomes, thyroid function tests and safety. Results: The primary endpoint at 6 months was achieved: the mental composite score (MCS) of Short Form 36 (SF-36) was significantly higher in group A compared to group B (PZ0.009). Four other dimension scores of the SF-36 and four dimension scores of the thyroid-specific patient-reported outcome (ThyPRO) significantly differed between the two groups, indicating better QoL in group A. After adjustment for variables, the early LT 4 administration strategy was found as an independent factor for only two scores of SF-36: the MCS and the general health (GH) score. There were no differences in GO, final thyroid status and changes in the anti-TSH receptor antibodies (TRAbs) levels between the two groups. No adverse cardiovascular event was reported. Conclusion: Early LT 4 administration post-radioactive iodine (RAI) could represent a safe potential benefit for patients with regard to QoL. The optimal strategy taking into account administered RAI activities and LT 4 treatment dosage and timing remains to be determined.

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A Randomized Comparison of Radioiodine Doses in Graves’ Hyperthyroidism

Cited by 167 publications

References 20 publications

Low iodine diet does not improve the efficacy of radioiodine for the treatment of Graves’ disease

Low iodine diet does not improve the efficacy of radioiodine for the treatment of Graves’ disease

Medical Management of Hyperthyroidism

Quality of life, clinical outcomes and safety of early prophylactic levothyroxine administration in patients with Graves' hyperthyroidism undergoing radioiodine therapy: a randomized controlled study

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