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Journal of Endocrinological Investigation

Erschienen in:

01.06.2022 | Review

Appropriate duration of antithyroid drug treatment as a predictor for relapse of Graves’ disease: a systematic scoping review

verfasst von: F. Azizi, H. Abdi, L. Mehran, A. Amouzegar

Erschienen in: Journal of Endocrinological Investigation | Ausgabe 6/2022

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Abstract

Background

Following the conventional 12–18 month antithyroid drug (ATD) treatment in Graves’ disease (GD), 50% of patients experience relapse of hyperthyroidism.

Objective

The aim of this systematic scoping review was critical appraisal of duration of ATD therapy in the last 80 years.

Methods

Articles were identified through the search of PubMed from January 1, 1941 to April 30, 2021. All study types were included. Articles were eligible if they reported data on the length of ATD treatment, particularly thyroid hormones and TSH receptor antibodies (TRAb) concentrations and specifically those with data on the remission and/or relapse rates.

Results

We described major progress regarding the duration of ATD therapy and related outcomes at every 20 years. Articles of 1941–1960 were mainly concerned with determination of favorable treatment, minimal effective dose, side effects and rate of remission after < 12-month ATD therapy. Studies with larger number of patients and longer follow-ups appeared in 1961–1980; higher remission rate after 18–24 months versus 6 months of ATD therapy was reported. Articles of 1981–2000 focused on identification of factors associated with high relapse rates after discontinuation of ATD. In 2001–2021, ATD became the first choice of treatment in many countries. However, 12–18 months of ATD therapy was arbitrarily chosen as the appropriate option. According to recent studies, persistent normalization of TRAb occurs after 5 years of methimazole therapy and ATD treatment of > 60 months could offer a 4-year remission rate of 85%.

Conclusion

Long-term ATD treatment for more than 60 months is safe and effective, has the highest remission rate and cures most patients with GD; hence, it should be considered as the most appropriate duration for ATD therapy in these patients.

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Titel: Appropriate duration of antithyroid drug treatment as a predictor for relapse of Graves’ disease: a systematic scoping review
verfasst von: F. Azizi
H. Abdi
L. Mehran
A. Amouzegar
Publikationsdatum: 01.06.2022
Verlag: Springer International Publishing
Erschienen in: Journal of Endocrinological Investigation / Ausgabe 6/2022
Elektronische ISSN: 1720-8386
DOI: https://doi.org/10.1007/s40618-021-01730-1

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Appropriate duration of antithyroid drug treatment as a predictor for relapse of Graves’ disease: a systematic scoping review

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Objective

Methods

Results

Conclusion

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