An update on the pharmacological management of hyperthyroidism due to Graves' disease.
Pharmacological treatment, usually by thionamides (carbimazole, methimazole, propylthiouracil) is, in addition to radioiodine therapy and thyroidectomy, one of the available therapies for Graves' hyperthyroidism. Thionamides represent the treatment of choice in pregnant women, during lactation, in children and adolescents and in preparation for radioiodine therapy or thyroidectomy. Side effects are relatively frequent but are in general mild and transient. Two main regimens are available: titration method (use of the lowest dose maintaining euthyroidism; duration: 12-18 months) and block-and-replace method. Neither one has clear advantages in terms of outcome but the latter method is associated with more frequent side effects. Hyperthyroidism relapses in approximately 50% of patients, to whom ablative therapy should be offered.
Bartalena
Luigi
L
Division of Endocrinology, Department of Clinical Medicine, Ospedale di Circolo, University of Insubria, Viale Borri, 57, 21100 Varese, Italy. l.bartalena@libero.it
Tanda
Maria Laura
ML
Bogazzi
Fausto
F
Piantanida
Eliana
E
Lai
Adriana
A
Martino
Enio
E
D013956:Antithyroid Agents / Q000009:adverse effects / Q000627:therapeutic use*; D019468:Disease Management; D006111:Graves Disease / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D006402:Hematologic Diseases / Q000097:blood / Q000139:chemically induced; D006801:Humans; D006980:Hyperthyroidism / Q000097:blood / Q000188:drug therapy* / Q000209:etiology
D013956:Antithyroid Agents