[L] Is there a role for antithyroid drug therapy in patients with TMNG or TA?

ATDs do not induce remission in patients with nodular thyroid disease. Therefore, discontinuation of treatment results in relapse (117,159). However, prolonged (life-long) ATD therapy may be the best choice for some individuals with limited longevity and increased surgical risk, including residents of nursing homes or other care facilities where compliance with radiation safety regulations may be difficult.

  • RECOMMENDATION 49 We suggest that long-term methimazole treatment of TMNG or TA be avoided, except in some elderly or otherwise ill patients with limited longevity who are able to be monitored regularly, and in patients who prefer this option. 2/+00

Technical remarks: Because long-term, low-dose ATD treatment in nodular hyperthyroidism can be difficult to regulate, frequent (every 3 months) monitoring is recommended, especially in the elderly (183).