Treatment of Graves' disease with the block-replace regimen of antithyroid drugs: the effect of treatment duration and immunogenetic susceptibility on relapse.
Antithyroid drugs are commonly used as first-line treatment for Graves' disease, but the optimum regimen for inducing remission remains unclear. We gave the block-replace regimen of carbimazole plus thyroxine to 100 patients for 6 or 12 months, to determine whether prolonged treatment is associated with fewer relapses. The remission rate one year after cessation of treatment was 59% with the 6 month course and 65% with 12 months; this was not significantly different. We also analysed HLA markers identified by restriction fragment length polymorphisms and could not confirm the recently reported associations of outcome with HLA-DR4 or with an HLA-DQA2 allele. These results show that six months treatment with a block-replace regimen of antithyroid drugs is probably sufficient, in the UK, to achieve maximum remission of Graves' disease and that there are no HLA markers which clearly predict outcome.
Weetman
A P
AP
Department of Medicine, University of Sheffield Clinical Sciences Centre, Northern General Hospital, UK.
Pickerill
A P
AP
Watson
P
P
Chatterjee
V K
VK
Edwards
O M
OM
D000328:Adult; D002231:Carbimazole / Q000627:therapeutic use*; D005260:Female; D006111:Graves Disease / Q000188:drug therapy* / Q000276:immunology; D006683:HLA-DQ Antigens / Q000032:analysis; D006684:HLA-DR Antigens / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D012150:Polymorphism, Restriction Fragment Length; D011446:Prospective Studies; D012008:Recurrence; D012074:Remission Induction; D013974:Thyroxine / Q000627:therapeutic use*
D006683:HLA-DQ Antigens; D006684:HLA-DR Antigens; D002231:Carbimazole; D013974:Thyroxine