Thyroxine therapy does not alter outcome
in patients with hyperthyroidism due to Graves' disease
(March 2003)
The background of the study.
Combined antithyroid drug and thyroxine (T4) therapy does not result
in a higher rate of prolonged remission in patients with hyperthyroidism
caused by Graves' disease than does therapy with an antithyroid
drug alone. This study evaluated whether T4 therapy given after
successful antithyroid drug therapy might increase the rate of prolonged
remission.
How the study was done.
The study subjects were 332 patients (284 women, 48 men; mean age,
42 years) with hyperthyroidism caused by Graves' disease. The patients
were treated with an antithyroid drug for 12 to 15 months, and had
to be normal during the last six months of therapy. Therapy then
was discontinued. One month later, the 225 patients (68 percent)
who were euthyroid and had a normal serum thyrotropin concentration
were randomly assigned to receive T4 or no therapy. Most of the
other 107 patients again had hyperthyroidism at this time. The 225
patients randomly assigned to receive T4 or no therapy were evaluated
periodically for two years.
The results of the study.
The frequency of recurrent overt hyperthyroidism in the T4-therapy
group was 18 percent in one year and 24 percent in two years, as
compared with 20 percent in one year and 32 percent in two years
in the no-T4-therapy group (differences not statistically significant).
The conclusions of the study.
Among patients with Graves' hyperthyroidism T4 therapy after
antithyroid drug therapy does not reduce the frequency of recurrent
hyperthyroidism
The original article.
Hoermann R, Quadbeck B, Roggenbuck U, Szabolcs I, Pfeilschifter
J, Meng W, Reschke K, Hackenberg K, Dettmann J, Prehn B, Hirche
H, Mann K. Relapse of Graves' disease after successful outcome of
antithyroid drug therapy: results of a prospective randomized study
on the use of levothyroxine. Thyroid 2002;12:1119-28.
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