Comparison of placebo with L-thyroxine alone or with carbimazole for treatment of sporadic non-toxic goitre.
The efficacy of treatment with TSH-suppressive doses of L-thyroxine (T4, 2.5 micrograms/kg body weight daily) either alone or combined with carbimazole (CBZ, 40 mg daily) was studied in 78 patients with sporadic non-toxic goitre in a prospective placebo-controlled double-blind randomised clinical trial. Treatment was given for 9 months, with 9 months of follow-up. A response to treatment as measured by ultrasonography was found in 58% of the T4 group, in 35% of the T4/CBZ group, and in 5% of the placebo group. The mean (SEM) decrease of thyroid volume at 9 months in the responders was 25% (2). After discontinuation of treatment, thyroid volume increased in the responders and had returned to base-line values after 9 months of follow-up. In the placebo group mean thyroid volume had increased by 6% (4) at 4 months, 20% (7) at 9 months, and 27% (8) at 18 months. The findings show that untreated sporadic non-toxic goitre continues to increase in size; T4 is effective in the treatment of the disorder; and the addition of CBZ has no therapeutic advantage.
Berghout
A
A
Department of Medicine, University of Amsterdam, The Netherlands.
Wiersinga
W M
WM
Drexhage
H A
HA
Smits
N J
NJ
Touber
J L
JL
D000328:Adult; D002231:Carbimazole / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006042:Goiter / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D013972:Thyrotropin / Q000037:antagonists & inhibitors / Q000097:blood; D013974:Thyroxine / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D014284:Triiodothyronine / Q000097:blood
D010919:Placebos; D014284:Triiodothyronine; D002231:Carbimazole; D013972:Thyrotropin; D013974:Thyroxine