[Recurrence of Graves-Basedow disease: the influence of treatment schedule].
BACKGROUND
The aim of the present study was to evaluate the possible influence of 2 different methods of treatment (antithyroid drugs and antithyroid drugs plus levothyroxine) on the number of recurrences in Graves' disease, as well as to study the possible prognostic factors for the evolution of the disease.


METHODS
Seventy-six patients allocated in to 2 treatment groups were studied. Group A included those patients treated with decreasing doses of carbimazole and group B included patients treated with high doses of carbimazole plus levothyroxine. The follow-up of these patients was carried out over a minimum of 36 months after discontinuation of treatment.


RESULTS
No significant differences were observed in either the clinical characteristics or hormonal or antibody values in both groups on initiation and at the end of treatment. The percentage of recurrence in group A patients during the first 12 months of follow-up was significantly greater (65% vs 23%, p < 0.001) than in group B. The percentage of recurrence equalled (62.8% vs 60.7%, p = NS) on prolongation of follow-up of up to 36 months. Recurrence was not correlated with either the clinical or biochemical parameters evaluated, although it did correlate with goiter size with recurrence observed in 100% of the patients with goiter greater than or equal to II.


CONCLUSIONS
The association of levothyroxine to treatment with carbimazole in Graves' disease delays the appearance of recurrence but does not significantly decrease it in comparison with the treatment with carbimazole in decreasing doses. Only the size of goiter on initiation of treatment may be a prognostic factor for disease evolution.
Goñi Iriarte
M J
MJ
Sección de Endocrinología, Hospital de Navarra, Pamplona.
Forga Llenas
L
L
Iriarte Beroiz
A
A
Apiñániz
E A
EA
Rodríguez Erdozain
R
R
Menéndez Torre
E
E
D000328:Adult; D002231:Carbimazole / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006111:Graves Disease / Q000188:drug therapy*; D006801:Humans; D008297:Male; D011379:Prognosis; D012008:Recurrence; D013974:Thyroxine / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors
D002231:Carbimazole; D013974:Thyroxine
Recidivas en la enfermedad de Graves-Basedow: influencia de la pauta de tratamiento.