Characteristics of Patients with Graves' Disease Whose Thyroid Hormone Levels Increase After Substituting Potassium Iodide for Methimazole in the First Trimester of Pregnancy

Yoshihara, Ai; Noh, Jaeduk Yoshimura; Watanabe, Natsuko; Kunii, Yo; Suzuki, Miho; Matsumoto, Masako; Suzuki, Nami; Hiruma, Marino; Morisaki, Mitsuha; Kawaguchi, Akiko; Sugino, Kiminori; Ito, Koichi

doi:10.1089/thy.2019.0392

Cited by 10 publications

(9 citation statements)

References 17 publications

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“…This retrospective cohort study was conducted at Ito Hospital in Tokyo (2). Pregnant women with Graves' disease whose treatment was switched from MMI to inorganic iodide during the first trimester and who gave birth between 2005 and 2018 were included.…”

Section: Methodsmentioning

confidence: 99%

Substituting Potassium Iodide For Methimazole In First-Trimester Pregnant Women With Graves' Disease May Unpredictably Worsen Hyperthyroidism

Pearce¹

2020

Clinical Thyroidology

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Section: Methodsmentioning

confidence: 99%

Substituting Potassium Iodide For Methimazole In First-Trimester Pregnant Women With Graves' Disease May Unpredictably Worsen Hyperthyroidism

Pearce¹

2020

Clinical Thyroidology

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“…Considering alternative treatments, a focus on the feasibility of using potassium iodide has emerged from studies in Japan [36,37]. In a cohort of 283 pregnant women with GD, treatment had been switched from MMI to potassium iodide in early pregnancy due to intolerance to PTU [36].…”

Section: Timing and Type Of Treatmentmentioning

confidence: 99%

“…A general concern about the use of iodine for the treatment of hyperthyroidism is that this treatment may be less effective than ATDs in the control of hyperthyroidism [6]. In a subsequent study from Japan [37], focus was on thyroid function in pregnant women who shifted from MMI to potassium iodide. In a cohort of 240 pregnant women, nearly half of the patients continued treatment throughout pregnancy and around 10% could not have their hyperthyroidism controlled solely by potassium iodide [37].…”

Section: Timing and Type Of Treatmentmentioning

confidence: 99%

“…In a subsequent study from Japan [37], focus was on thyroid function in pregnant women who shifted from MMI to potassium iodide. In a cohort of 240 pregnant women, nearly half of the patients continued treatment throughout pregnancy and around 10% could not have their hyperthyroidism controlled solely by potassium iodide [37]. From a clinical point, the identification of these patients is important considering the choice of treatment, but no specific predictors of this tendency to escape from the antithyroid effect of iodine could be identified in that study [37].…”

Section: Timing and Type Of Treatmentmentioning

confidence: 99%

“…In a cohort of 240 pregnant women, nearly half of the patients continued treatment throughout pregnancy and around 10% could not have their hyperthyroidism controlled solely by potassium iodide [37]. From a clinical point, the identification of these patients is important considering the choice of treatment, but no specific predictors of this tendency to escape from the antithyroid effect of iodine could be identified in that study [37]. Further studies on the benefits and risks of treatment with potassium iodide in early pregnancy are needed including studies from populations with different levels of iodine intake.…”

Section: Timing and Type Of Treatmentmentioning

confidence: 99%

See 2 more Smart Citations

Antithyroid drugs and birth defects

Andersen

2020

Thyroid Res

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Antithyroid drugs (ATDs) are preferred for the treatment of hyperthyroidism caused by Graves' disease in pregnant women. The drugs have been a recognized treatment for decades, and a general risk of side effects is known. For the use of ATDs in pregnancy, a concern about teratogenic side effects has been brought forward since the 1970s. In more recent years, a number of large observational studies have added new evidence and quantified the risk of birth defects associated with different types of ATDs. The findings that both Methimazole (MMI) and Propylthiouracil (PTU) are associated with birth defects have challenged the clinical recommendations on the treatment of hyperthyroidism in pregnancy, and certain aspects remain unclarified. In this review, the current evidence on the risk of birth defects associated with the use of ATDs in early pregnancy is described, and determinants of causality are discussed. This includes the current evidence of a biological gradient and the role of maternal thyroid function per se. Finally, clinical aspects of the timing and type of treatment is discussed, and future perspectives are addressed. Current evidence corroborates a risk of birth defects associated with MMI while more evidence is needed to determine the teratogenic potential of PTU. Detailed assessment of type and timing of exposure in large cohorts are needed. Moreover, studies investigating alternative or new treatments are warranted.

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Maternal Hyperthyroidism

Gkastaris

Krassas²

2022

Thyroid Diseases in Pregnancy

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Characteristics of Patients with Graves' Disease Whose Thyroid Hormone Levels Increase After Substituting Potassium Iodide for Methimazole in the First Trimester of Pregnancy

Cited by 10 publications

References 17 publications

Substituting Potassium Iodide For Methimazole In First-Trimester Pregnant Women With Graves' Disease May Unpredictably Worsen Hyperthyroidism

Substituting Potassium Iodide For Methimazole In First-Trimester Pregnant Women With Graves' Disease May Unpredictably Worsen Hyperthyroidism

Antithyroid drugs and birth defects

Maternal Hyperthyroidism

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