Prolonged low-dose
antithyroid drug therapy results in a high remission rate in Graves'
hyperthyroidism
(November 2003)
The background of the study.
Some patients with hyperthyroidism caused by Graves' disease who
are treated with an antithyroid drug remain well after treatment
is stopped; they are said to be in remission. This study was done
to determine if prolonged treatment with a low dose of antithyroid
drug resulted in a high rate of remission.
How the study was done.
The study subjects were 44 women and 13 men with hyperthyroidism
caused by Graves' disease. They were treated initially with moderate
doses of methimazole or propylthiouracil. The doses were reduced
gradually as the patients improved. Those patients who remained
well were treated with a very low dose of antithyroid drug (5 mg
of methimazole or 50 mg of propylthiouracil) every other day for
six months. Treatment was then stopped, and the patients were evaluated
periodically for two years.
The results of the study.
Among the 57 patients who completed the antithyroid drug treatment
program, 46 (81 percent) remained well and 11 (19 percent) had recurrent
hyperthyroidism during the two-year follow-up period. The recurrence
occurred within eight months in 9 of the 11 patients (82 percent).
The conclusions of the study.
Prolonged treatment with a low dose of antithyroid drug is associated
with a high rate of persistent remission in patients with hyperthyroidism
caused by Graves' disease.
The original article.
Kashiwai T, Hidaka Y, Takano T, Tatsumi K, Izumi Y, Shimaoka Y,
Tada H, Takeoka K, Amino N. Practical treatment with minimum maintenance
dose of anti-thyroid drugs for prediction of remission in Graves'
disease. Endocr J 2003;50:45-9.
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