title: A 6-year follow-up of a randomized prospective trial comparing methimazole treatment with or without exogenous L-thyroxine in Chinese patients with Graves' disease.
abstract: OBJECTIVE
  Antithyroid drug therapy is one of the main medical treatments for Graves' disease. There have been conflicting reports as to whether the addition of exogenous L-thyroxine improves remission rates more than antithyroid drugs alone. This randomized, controlled and prospective clinical trial was undertaken to investigate the long-term outcome of methimazole treatment with or without exogenous L-thyroxine in Chinese patients.
  
  
  METHODS
  145 patients with Graves' disease were randomly divided into 3 groups and all patients initially received 30 mg of methimazole daily for at least 1 month and then followed the titration -regimen with or without L-thyroxine: group 1 (30 mg→20 mg→15 mg→10 mg→5 mg); group 2 (30 mg→20 mg→15 mg→10 mg+L-thyroxine→5 mg+L-thyroxine); group 3 (30 mg→20 mg→15 mg→10 mg+L-thyroxine→5 mg+L-thyroxine→2.5 mg+L-thyroxine). The drug therapy was discontinued after 5 months of the final dose.
  
  
  RESULTS
  16 out of 46 patients in group 1 (34.8%), 12 out of 47 in group 2 (25.5%) and 16 out of 52 in group 3 (30.8%) had a recurrence of Graves' disease within 6-year follow-up after drug withdrawal. Survival Analysis showed no significant differences in the remission rates between any 2 groups, despite the remission rates in group 2 and 3 were slightly higher than that in group 1.
  
  
  CONCLUSIONS
  The addition of L-thyroxine to methimazole treatment in patients with Graves' disease neither improves nor prevents the remission or recurrence of Graves' disease in China.
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Xi'an Jiaotong University Health Science Center.
authors.forename: X
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Xi'an Jiaotong University Health Science Center.
authors.forename: W
authors.initials: W
authors.lastname: Qiang
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Xi'an Jiaotong University Health Science Center.
authors.forename: X
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Xi'an Jiaotong University Health Science Center.
authors.forename: L
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Xi'an Jiaotong University Health Science Center.
authors.forename: S
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Xi'an Jiaotong University Health Science Center.
authors.forename: A
authors.initials: A
authors.lastname: Gao
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Xi'an Jiaotong University Health Science Center.
authors.forename: S
authors.initials: S
authors.lastname: Gao
authors.affiliation: Department of Endocrinology, First Affiliated Hospital of Xi'an Jiaotong University Health Science Center.
authors.forename: B
authors.initials: B
authors.lastname: Shi
mesh_terms: D000293:Adolescent; D000328:Adult; D013956:Antithyroid Agents / Q000627:therapeutic use*; D002648:Child; D002681:China; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006111:Graves Disease / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008713:Methimazole / Q000627:therapeutic use*; D008875:Middle Aged; D012008:Recurrence; D013974:Thyroxine / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D013956:Antithyroid Agents; D008713:Methimazole; D013974:Thyroxine