Long-term follow-up result of antithyroid drug treatment of Graves’ hyperthyroidism in a large cohort

Abstract

Objective: This study evaluated the efficacy of antithyroid drugs (ATD) and risk factors associated with the recurrence of Graves’ hyperthyroidism using a comprehensive retrospective cohort. Methods: We included 1,829 patients newly diagnosed with Graves’ hyperthyroidism, with sufficient follow-up data. Clinical outcomes of the patients and risk factors associated with recurrence-free survival, including the changes in thyrotropin receptor antibody, were evaluated. Results: The median age of the patients was 44.5 years, and 69% were female. Among the patients, 1,235 had a chance to withdraw ATD after a median of 23 (interquartile range [IQR] 17.0–35.5) months of treatment. The first remission rate was 55.6% during a median of 72.7 months of follow-up. After the first recurrence, 95% of patients underwent the second course of ATD treatment for a median of 21.1 (IQR 14.8–31.7) months, and the remission rate was 54.1%. During a median of 67 months of follow-up, 7.7% of patients underwent surgery, and 10.5% underwent radioactive iodine therapy. Approximately 30% were still on ATD therapy for recurrent disease or prolonged low-dose maintenance. Younger age (< 45 years), male sex, and fluctuating or smoldering of TRAb levels were independent risk factors of the first recurrence after ATD treatment. Conclusions: ATD treatment is an acceptable option for the initial treatment of Graves’ hyperthyroidism, as well as for recurrent disease. The optimal treatment period for ATD treatment needs to be determined using the individual risk factors of recurrence.

Evaluation of YouTube As A Source For Graves' Disease Information: Is High‐Quality Guideline‐Based Information Available?

“…4,49 This is particularly significant as the recurrence rate with ATD use is high, and recurrence may negatively impact patient quality of life. 50,51 These findings indicate a significant gap between the content available on YouTube and the evidence-based guidelines recommended by medical experts. While creating high-quality, understandable, and engaging medical information content can be challenging, it remains a worthy cause, as increasing patients' exposure to high-quality medical information significantly increases their decision-making efficacy.…”

“…TRAb testing is a mainstay for evaluating ATD treatment effectiveness, and an increased recurrence rate is associated with patients lost to follow‐up for TRAb testing after ATD therapy 4,49 . This is particularly significant as the recurrence rate with ATD use is high, and recurrence may negatively impact patient quality of life 50,51 …”

“… 4 , 49 This is particularly significant as the recurrence rate with ATD use is high, and recurrence may negatively impact patient quality of life. 50 , 51 …”

Ultrasound measurement of vastus lateralis and vastus medialis muscle parameters to identify chronic thyrotoxic myopathy

“…The etiology of hyperthyroidism is classified into 12 categories, such as Graves' disease (GD), toxic multinodular goiter (TMNG), and toxic adenoma (TA) (2). Hyperthyroidism is most commonly caused by an autoimmune disorder called GD in which thyroid-stimulating hormone (TSH) receptor antibody (TRAb) stimulates thyroid follicular cells, leading to thyrotoxicosis (1,3). The clinical manifestation of hyperthyroidism can involve skeletal muscles.…”

Outcomes of Long-Term Follow-up of Patients Receiving Antithyroid Medication for Hyperthyroidism due to Graves' Disease

“…Thyrotropin (also known as thyroid stimulating hormone (TSH)) receptors antibodies (TRAb) activates thyroid follicular cells in the autoimmune condition known as Graves' hyperthyroidism, which causes thyrotoxicosis and swelling of the thyroid glands (1,2) .…”