Comparison of Methimazole and Propylthiouracil in Patients with Hyperthyroidism Caused by Graves’ Disease

Nakamura, Hirotoshi; Noh, Jaeduk Yoshimura; Itoh, Koichi; Fukata, Shuji; Miyauchi, Akira; Hamada, Noboru

doi:10.1210/jc.2006-2135

Cited by 247 publications

(173 citation statements)

References 14 publications

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“…This study also showed that the incidence of adverse effects in patients treated with MMI was significantly lower than in those treated with PTU [25]. Based on these findings, the JTA guidelines recommend MMI as the first-choice ATD for the treatment of compensated Graves' disease, except during early pregnancy [26].…”

Section: ■ Recommendationmentioning

confidence: 74%

2016 Guidelines for the management of thyroid storm from The Japan Thyroid Association and Japan Endocrine Society (First edition)

et al. 2016

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Section: ■ Recommendationmentioning

confidence: 74%

2016 Guidelines for the management of thyroid storm from The Japan Thyroid Association and Japan Endocrine Society (First edition)

et al. 2016

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“…This will be women who started ATD therapy recently (<6 months), who still have suppressed TSH, who have a relatively high serum T 3 (76), high levels of TRAb, large goitre, active orbitopathy, or other signs of active disease. In such women, MMI/CMZ should be replaced with PTU in early pregnancy (preferably in gestational week 5), using a dose ratio of 1:20 (77,78,79), e.g. 200 mg PTU per day replaces 10 mg MMI (or 15 mg CMZ).…”

Section: European Journal Of Endocrinologymentioning

confidence: 99%

ENDOCRINOLOGY IN PREGNANCY: Pregnancy and the incidence, diagnosing and therapy of Graves’ disease

Laurberg

Andersen

2016

European Journal of Endocrinology

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Thyroid hormones are essential developmental factors, and Graves' disease (GD) may severely complicate a pregnancy. This review describes how pregnancy changes the risk of developing GD, how early pregnancy by several mechanisms leads to considerable changes in the results of the thyroid function tests used to diagnose hyperthyroidism, and how these changes may complicate the diagnosing of GD. Standard therapy of GD in pregnancy is anti-thyroid drugs. However, new studies have shown considerable risk of birth defects if these drugs are used in specific weeks of early pregnancy, and this should be taken into consideration when planning therapy and control of women who may in the future become pregnant. Early pregnancy is a period of major focus in GD, where pregnancy should be diagnosed as soon as possible, and where important and instant change in therapy may be warranted. Such change may be an immediate stop of anti-thyroid drug therapy in patients with a low risk of rapid relapse of hyperthyroidism, or it may be an immediate shift from methimazole/carbimazole (with risk of severe birth defects) to propylthiouracil (with less risk), or maybe to other types of therapy where no risk of birth defects have been observed. In the second half of pregnancy, an important concern is that not only the mother with GD but also her foetus should have normal thyroid function.Thyroid hormones are essential developmental factors as first shown by Gudernatsch when he, in 1912, fed tadpoles thyroid tissue and observed metamorphosis (1). In mammals, thyroid hormones are especially of importance for brain development (2, 3), and even a few months with lack of thyroid hormones in infant life may lead to irreversible brain damage. This is the background for the universal screening for congenital hypothyroidism performed in many countries. However, thyroid hormones are also important for normal pregnancy, and maternal thyroid disease may severely increase the risk of pregnancy complications, including Invited author's profile Peter Laurberg was Clinical Professor of Internal Medicine and Endocrinology, Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark. His research mainly focused on thyroid disease prevention, epidemiology, diagnosing and therapy, including studies on iodine and thyroid, and pregnancy and thyroid. He had special research interest on the risk from and optimal management of autoimmune hypo-and hyperthyroidism in pregnancy and post-partum, management of Graves' disease in general, and how the burden of thyroid disease can be minimized by adjusting the population's iodine intake. He has coauthored several international guidelines on thyroid disease management, including management of thyrotoxicosis, and thyroid disease in pregnancy. Peter Laurberg died June 20, 2016.

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“…The JTA reported that MMI 15 mg/d is suitable for mild and moderate Graves' disease, whereas MMI 30 mg/d is advisable for severe cases. Propylthiouracil is not recommended for initial use because of high frequency of side effects (5).…”

Section: Nobuyuki Aminomentioning

confidence: 99%

The American Thyroid Association and American Association of Clinical Endocrinologists Hyperthyroidism and Other Causes of Thyrotoxicosis Guidelines: Viewpoints from Japan and Korea

Yamashita

Amino

Shong

2011

Thyroid

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Comparison of Methimazole and Propylthiouracil in Patients with Hyperthyroidism Caused by Graves’ Disease

Abstract: MMI 15 mg/d is suitable for mild and moderate GD, whereas MMI 30 mg/d is advisable for severe cases. PTU is not recommended for initial use.

Cited by 247 publications

References 14 publications

2016 Guidelines for the management of thyroid storm from The Japan Thyroid Association and Japan Endocrine Society (First edition)

2016 Guidelines for the management of thyroid storm from The Japan Thyroid Association and Japan Endocrine Society (First edition)

ENDOCRINOLOGY IN PREGNANCY: Pregnancy and the incidence, diagnosing and therapy of Graves’ disease

The American Thyroid Association and American Association of Clinical Endocrinologists Hyperthyroidism and Other Causes of Thyrotoxicosis Guidelines: Viewpoints from Japan and Korea

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