Twelve Years' Experience of Antithyroid Treatment

Antithyroid treatment: a personal series

“…In a study of the work of nine writers from 1953 to 1964 incidences of remission varied between 45% and 72%, the minimum follow-up period being 4 years. Using this standard of assessment, the results in this series show an incidence of 69% of remissions after 4 years, and in the writer's earlier paper (Willcox, 1962)-64%.…”

“…The routine period of treatment of 1 year was adopted in 1952 in view of the current opinion of those who had made extensive studies of thiouracil up to that time (Douglas & Kennie, 1952;Williams, 1950). Moreover, theoretical considerations of the action of antithyroid drugs on the production of hormone in the gland would support the idea of the need for treatment over a long period.…”

“…For this reason patients are kept under monthly observation for the first 6 months and thereafter are seen at least as often as 2 monthly. It is important that personal supervision be exercised by one doctor conversant with the aim of treatment (Riddell, 1963;Willcox, 1962) in order to avoid drug toxicity and overdosage. In many cases dosage has been on the lines set out in Table 1 though it is not suggested that this routine should be adhered to.…”

“…Since 1951 carbimazole has been highly favoured in this country, being considered the least toxic agent in large-scale surveys (Burrell, Fraser & Doniach, 1956). Later (Willcox, 1962), it was shown that, with careful personal selection of suitable cases and with personal dosage control, fifty-three (64%) of eighty-three cases were successfully treated, without relapsing, with methyl thiouracil and fifty-five (82%) of sixty-seven cases with carbimazole. Fifty-eight per cent of this group had been followed up for 5 years or longer.…”