Thyroid-associated ophthalmopathy; quality of life follow-up of patients randomized to treatment with antithyroid drugs or radioiodine.
OBJECTIVE
The objective of this study was to investigate quality of life (QoL) in patients with Graves' disease treated with radioiodine or antithyroid drugs.


METHODS
The design of the study consists of an open, prospective, randomized multicenter trial between radioiodine and medical treatment. A total of 308 patients were included in the study group: 145 patients in the medical group and 163 patients in the radioiodine group. QoL was measured with a 36-item Short Form Health Status Survey questionnaire (SF-36) at six time points during the 48-month study period.


RESULTS
Patient who developed or got worse of thyroid-associated ophthalmopathy (TAO) at any time point during the 4-year study period (TAO group) had lower QoL when no respect was paid to the mode of treatment. TAO occurred in 75 patients who had radioiodine treatment at some time point during the study period as compared with TAO in 40 medically treated patients (P<0.0009). Comparisons between the group of patients who have had TAO versus the group without TAO, in relation to treatments and time, showed significantly decreased QoL scores for the TAO groups at several time points during the study. In patients without TAO, there were no differences in QoL related to mode of treatment.


CONCLUSIONS
The QoL in patients with Graves' ophthalmopathy was similar in radioiodine and medically treated patients, but patients who developed or had worsening of TAO had decreased QoL independent of mode of treatment. Furthermore, patients with TAO recovered physically within 1 year but it took twice as long for them to recover mentally.
Abraham-Nordling
Mirna
M
Department of Clinical Sciences, Division of Surgery, Danderyd Hospital, Karolinska Institute, Stockholm, Sweden. mirna.abraham.nordling@ki.se
Wallin
Göran
G
Träisk
Frank
F
Berg
Gertrud
G
Calissendorff
Jan
J
Hallengren
Bengt
B
Hedner
Pavo
P
Lantz
Mikael
M
Nyström
Ernst
E
Asman
Peter
P
Lundell
Göran
G
Törring
Ove
O
D000328:Adult; D000368:Aged; D013956:Antithyroid Agents / Q000627:therapeutic use*; D005260:Female; D006111:Graves Disease / Q000188:drug therapy / Q000532:radiotherapy; D049970:Graves Ophthalmopathy / Q000188:drug therapy* / Q000532:radiotherapy*; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008713:Methimazole / Q000627:therapeutic use; D008875:Middle Aged; D011788:Quality of Life; D016896:Treatment Outcome
D013956:Antithyroid Agents; D007457:Iodine Radioisotopes; D008713:Methimazole