title: Relapse following antithyroid drug therapy for Graves' hyperthyroidism.
abstract: OBJECTIVE
  In most patients with hyperthyroidism caused by Graves' disease, antithyroid drug (ATD) therapy is followed by a gradual amelioration of the autoimmune abnormality, but about half of the patients will experience relapse of hyperthyroidism when the ATDs are withdrawn after a standard 1 to 2 years of therapy. This is a major drawback of ATD therapy, and a major concern to patients. We review current knowledge on how to predict and possibly reduce the risk of such relapse.
  
  
  RESULTS
  Several patient and disease characteristics, as well as environmental factors and duration of ATD therapy, may influence the risk of relapse after ATD withdrawal. Depending on the presence of such factors, the risk of relapse after ATD withdrawal may vary from around 10 to 90%. Risk factors for relapse should be taken into account when choosing between therapeutic modalities in a patient with newly diagnosed disease, and also when discussing duration of ATD therapy.
  
  
  CONCLUSIONS
  Prolonged low-dose ATD therapy may be feasible in patients with high risk of relapse, such as children and patients with active Graves' orbitopathy, and in patients with previous relapse who prefer such therapy rather than surgery or radioiodine.
authors.affiliation: aDepartment of Endocrinology, Aalborg University Hospital bDepartment of Clinical Medicine, Aalborg University, Aalborg, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Laurberg
authors.forename: Anne
authors.initials: A
authors.lastname: Krejbjerg
authors.forename: Stine Linding
authors.initials: SL
authors.lastname: Andersen
mesh_terms: D013956:Antithyroid Agents / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D006111:Graves Disease / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D006801:Humans; D008713:Methimazole / Q000008:administration & dosage*; D011989:Receptors, Thyrotropin / Q000187:drug effects* / Q000276:immunology; D012008:Recurrence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000276:immunology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D013956:Antithyroid Agents; D011989:Receptors, Thyrotropin; D008713:Methimazole