Antithyroid drug therapy for Graves' hyperthyroidism: is long-term administration of a small maintenance dose necessary?
This retrospective study serves as an inquiry into the common practice of long-term administration of small maintenance doses of either methyl-mercaptoimidazole (MMI) or propylthiouracil (PTU) to Graves' hyperthyroid patients who became euthyroid with primary large doses of the same drugs. One hundred and two patients with Graves' hyperthyroidism treated with antithyroid drug (ATD) were studied. Sixty-one were treated with conventional long term therapy and 41 were treated with short-term therapy. Small maintenance doses of ATDs were not administered to the short-term therapy patients. The duration of long-term therapy was 28.6 +/- 20.2 months (from 12 to 48 months) and that of short-term therapy was 8.4 +/- 1.8 months (from 5 to 11). Post therapy and follow-up observation continued for 19.0 +/- 2.7 months (16-25 months) in both long-term and short-term patients. Of the 61 long-term therapy patients, 20 were relapsed and 41 (67.2%) continue to remain in remission. So too, of the 41 short-term therapy patients, 14 relapsed and 27 (65.9%) still remain in remission. There was no statistical difference between the long-term and short-term therapy group in age, sex, duration of symptoms before diagnosis, antithyroid antibodies, radioactive iodine uptake, free thyroid hormone levels or goiter size before treatment or in TBII levels at cessation of ATD. It is concluded that 'short-term ATD therapy' without a maintenance dose is sufficient and saves several months of the patient's and clinician's time.
Noguchi Thyroid Clinic and Hospital Foundation, Oita, Japan.
J
J
Tajiri
S
S
Noguchi
M
M
Morita
M
M
Tamaru
N
N
Murakami
D000328:Adult; D001323:Autoantibodies / Q000097:blood; D004334:Drug Administration Schedule; D005260:Female; D006111:Graves Disease / Q000188:drug therapy*; D006801:Humans; D018828:Immunoglobulins, Thyroid-Stimulating; D008297:Male; D008713:Methimazole / Q000008:administration & dosage* / Q000627:therapeutic use; D008875:Middle Aged; D011441:Propylthiouracil / Q000008:administration & dosage* / Q000627:therapeutic use; D012074:Remission Induction; D012189:Retrospective Studies; D013961:Thyroid Gland / Q000276:immunology; D013972:Thyrotropin / Q000097:blood; D014284:Triiodothyronine / Q000097:blood
D001323:Autoantibodies; D018828:Immunoglobulins, Thyroid-Stimulating; D014284:Triiodothyronine; D008713:Methimazole; D011441:Propylthiouracil; D013972:Thyrotropin