title: What is the evidence behind the evidence-base? The premature death of block-replace antithyroid drug regimens for Graves' disease.
abstract: Block-replace and titration antithyroid drug regimens both give similar rates of medium- to long-term remission of hyperthyroid Graves' disease. Recent meta-analysis, however, has suggested that titration regimens may be preferable owing to a higher rate of adverse events seen in the block-replace arms of published comparative studies. This article critically re-evaluates the evidence upon which these meta-analyses were based. We suggest that there is little objective evidence that is pertinent to current clinical practice to separate block-replace from titration antithyroid drug regimens and that both remain satisfactory approaches to the medical management of hyperthyroid Graves' disease.
authors.affiliation: Department of Endocrinology, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
authors.forename: Salman
authors.initials: S
authors.lastname: Razvi
authors.forename: Bijay
authors.initials: B
authors.lastname: Vaidya
authors.forename: Petros
authors.initials: P
authors.lastname: Perros
authors.forename: Simon H S
authors.initials: SH
authors.lastname: Pearce
mesh_terms: D013956:Antithyroid Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019317:Evidence-Based Medicine; D006111:Graves Disease / Q000188:drug therapy*
chemical_list: D013956:Antithyroid Agents