Hyperthyroidism (primary).
BACKGROUND
Hyperthyroidism is characterised by high levels of serum thyroxine and triiodothyronine, and low levels of thyroid-stimulating hormone. The main causes of hyperthyroidism are Graves' disease, toxic multinodular goitre, and toxic adenoma. About 20 times more women than men have hyperthyroidism.


METHODS
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of drug treatments for primary hyperthyroidism? What are the effects of surgical treatments for primary hyperthyroidism? What are the effects of treatments for subclinical hyperthyroidism? We searched: Medline, Embase, The Cochrane Library and other important databases up to June 2007 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).


RESULTS
We found 14 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.


CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: adding thyroxine to antithyroid drugs (carbimazole, propylthiouracil, and thiamazole), antithyroid drugs (carbimazole, propylthiouracil, and thiamazole), radioactive iodine, and thyroidectomy.
Nygaard
Birte
B
Department of Endocrinology, Herlev Hospital, University of Copenhagen, Herlev Ringvej, Copenhagen, Denmark.
D013956:Antithyroid Agents / Q000627:therapeutic use; D006111:Graves Disease / Q000188:drug therapy; D006801:Humans; D006980:Hyperthyroidism / Q000188:drug therapy; D015994:Incidence; D008713:Methimazole; D013972:Thyrotropin / Q000097:blood
D013956:Antithyroid Agents; D008713:Methimazole; D013972:Thyrotropin