title: Predictors of long-term remission in patients with Graves' disease: a single center experience.
abstract: Antithyroid drugs (ATDs) remain the first-line therapy in patients with Graves' disease (GD), despite a high relapse rate. The purpose of this study was to identify the predictors of remission in patients with GD treated with ATDs-retrospective study at an endocrine referral service in Northern Greece. Two-hundred and eleven patients met the study's criteria. Females (p = 0.049), non-smokers (p = 0.017), patients without ophthalmopathy (p = 0.033), and those developing pharmaceutical hypothyroidism (p = 0.018) experienced longer duration of remission. Duration of remission was positively associated with therapy duration (r s = 0.151, p = 0.030), maximum TSH levels during (r s = 0.241, p = 0.001), at the end (r s = 0.280, p < 0.001) and 3 months after therapy (r s = 0.341, p = 0.003). There was a negative association with free T4 (FT4) (r s = -0.426, p < 0.001) and free triiodothyronine (FT3) (r s = -0.467, p = 0.038) levels at 6 months after ATDs discontinuation. In multiple-regression analysis, only duration of the first ATDs course for more than 24 months independently predicted duration of remission. Female gender, non-smoking, the absence of orbitopathy, treatment duration, pharmaceutical hypothyroidism, higher TSH levels during, at the end and 3 months after ATDs discontinuation, and lower FT4 and FT3 levels 6 months after therapy were associated with longer duration of remission. However, only duration of ATDs therapy for more than 24 months independently predicted predict long-term remission in GD.
authors: Department of Endocrinology, Hippokration Hospital of Thessaloniki, 10 Sarantaporou Street, 54 640, Thessaloniki, Greece, anagnwstis.pan@yahoo.gr.
authors: Panagiotis
authors: P
authors: Anagnostis
authors: Fotini
authors: F
authors: Adamidou
authors: Stergios A
authors: SA
authors: Polyzos
authors: Simoni
authors: S
authors: Katergari
authors: Eleni
authors: E
authors: Karathanasi
authors: Chrisanthi
authors: C
authors: Zouli
authors: Athanasios
authors: A
authors: Panagiotou
authors: Marina
authors: M
authors: Kita
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D013956:Antithyroid Agents / Q000627:therapeutic use*; D005260:Female; D006111:Graves Disease / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
chemical_list: D013956:Antithyroid Agents
references: Trends Endocrinol Metab. 2005 Jul;16(5):243-8
references: 15950483
references: Clin Endocrinol (Oxf). 1998 Oct;49(4):451-7
references: 9876342
references: J Coll Physicians Surg Pak. 2009 Nov;19(11):690-3
references: 19889263
references: J Clin Endocrinol Metab. 2000 Mar;85(3):1038-42
references: 10720036
references: J Clin Endocrinol Metab. 1990 Mar;70(3):675-9
references: 1689737
references: Praxis (Bern 1994). 2006 Jul 19;95(29-30):1121-7
references: 16916174
references: Endocrine. 2013 Feb;43(1):230-2
references: 22983830
references: J Pediatr Endocrinol Metab. 2011;24(5-6):257-63
references: 21823520
references: Endocr Pract. 2011 May-Jun;17(3):456-520
references: 21700562
references: Rev Invest Clin. 2002 Jul-Aug;54(4):307-10
references: 12415954
references: N Engl J Med. 1991 Apr 4;324(14):947-53
references: 1900575
references: Eur J Endocrinol. 2005 Oct;153(4):489-98
references: 16189168
references: Thyroid. 2006 Mar;16(3):295-302
references: 16571093
references: Q J Med. 1994 Jun;87(6):337-41
references: 7913766
references: Clin Endocrinol (Oxf). 1998 May;48(5):585-92
references: 9666870
references: Clin Endocrinol (Oxf). 1989 Aug;31(2):209-18
references: 2481576
references: Clin Endocrinol (Oxf). 1996 Nov;45(5):511-6
references: 8977745
references: Thyroid. 2005 Sep;15(9):1047-54
references: 16187913
references: J Clin Endocrinol Metab. 2008 Oct;93(10):3817-26
references: 18628515
references: N Engl J Med. 2008 Jun 12;358(24):2594-605
references: 18550875
references: Endocrine. 2013 Apr;43(2):318-26
references: 23065592
references: Acta Endocrinol (Copenh). 1989 Jun;120(6):689-701
references: 2567102
references: Thyroid. 1997 Jun;7(3):369-75
references: 9226205
references: J Endocrinol Invest. 1992 Dec;15(11):815-20
references: 1283984
references: Thyroid. 2010 Sep;20(9):949-54
references: 20629556
references: Clin Invest Med. 2009 Jun 01;32(3):E199-205
references: 19480735
references: Endocr J. 2011;58(2):95-100
references: 21206137
references: Eur J Nucl Med. 1996 Feb;23(2):118-22
references: 8925844
references: Clin Endocrinol (Oxf). 1999 Jan;50(1):127-32
references: 10341866
references: Endocr J. 2007 Dec;54(5):713-20
references: 17675761
references: J Am Geriatr Soc. 1994 May;42(5):513-6
references: 8176146
references: J Endocrinol Invest. 1989 Oct;12(9):589-95
references: 2573625
references: Postgrad Med J. 1995 Apr;71(834):222-3
references: 7784282
references: Eur J Endocrinol. 2001 May;144(5):475-83
references: 11331213
references: Pediatrics. 2008 Mar;121(3):e481-8
references: 18267979
references: N Engl J Med. 2005 Mar 3;352(9):905-17
references: 15745981