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Very-long-term methimazole therapy is effective in patients with hyperthyroidism caused by Graves’ disease
The background of the study. Some patients with
hyperthyroidism caused by Graves’ disease who are treated
with an antithyroid drug have recurrent hyperthyroidism after the
drug is stopped. This study compared the effects of prolonged antithyroid
drug (methimazole) and radioiodine (I-131) therapy in patients with
recurrent hyperthyroidism.
How the study was done. The study group consisted of 104 patients with hyperthyroidism caused by Graves’ disease who were treated with methimazole and had recurrent hyperthyroidism after the drug was stopped. These patients were randomly assigned to receive methimazole for 10 years or I-131 therapy. All the patients were evaluated regularly for 10 years, and the number of visits at which they had normal, low, or high serum thyrotropin (TSH) concentrations was determined.
The results of the study. Sixty-seven patients completed the 10-year study, 26 in the methimazole group and 41 in the I-131 group. None of the patients in the methimazole group had a serious drug reaction. Serum TSH was measured 627 times in the methimazole-treated patients; 48 values (8 percent) were low and 37 (6 percent) were high. Serum TSH was measured 989 times in the patients in the I-131 group; 90 values (9 percent) were low and 127 (13 percent) were high.
At the end of the study, 16 of the 41 patients (39 percent) in the I-131 group had normal thyroid function, and 25 (61 percent) had hypothyroidism. At the same time, all 26 patients in the methimazole group had normal thyroid function. The mean age, scores on a quality-of-life questionnaire, weight, blood pressure, and pulse rate in the two groups were similar, as were their serum TSH and thyroid hormone concentrations.
The conclusions of the study. Patients with recurrent hyperthyroidism caused by Graves’ disease can be treated effectively and safely with methimazole for 10 years, as well as with I-131.
The original article. Azizi F, Ataie L, Hedayati
M, Mehrabi Y, Sheikholeslami F. Effect of long-term continuous methimazole
treatment of hyperthyroidism: comparison with radioiodine. Eur J
Endocrinol 2005;152:695-701.
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| Thyroid Digest Index | | | July 2005 Thyroid Digest |
