High-dose versus low-dose block-and-replace treatment for a first episode of Graves’ disease
Authors' conclusion
We observed similar relapse rates in patients with a first episode of GD receiving up to 50% less ATD and 30% less levothyroxine dose than high-dose B+R regimen.
Study context
- Population
- Newly diagnosed Graves' disease (GD) (1990–2022) treated with ATD in B+R regimen for ≥12 months and followed ≥1 year after ATD discontinuation or until relapse
- Participants
- 60 vs 60
- Exposure
- High-dose vs low-dose block-and-replace ATD regimen
- HDn = 60
- LDn = 60
- Outcome
- Euthyroidism point-prevalence
- Follow-up
- 6, 12 and 18 months
Methodological detailstwo academic centres
- Two academic centres
Main finding
As reported in the abstract
- Point-prevalence of euthyroidism not different between HD and LD
- HD vs LD: P = 0.460 at 6 months
- HD vs LD: P = 0.194 at 12 months
- HD vs LD: P = 0.370 at 18 months
Observational data: associations, not effects.
Further findings
TED · 18 months
P = 0.242
Relapse after first ATD course
P = 0.707
ATD dose · lower with LD
P < 0.001
Levothyroxine dose · lower with LD
P < 0.001
Time to relapse
P = 0.109
Safety
ATD-related AEs
No AE
P = 0.707
ATD-related adverse events (AEs)
- No differences in number or type of ATD-related AEs
Original publication
High-dose versus low-dose block-and-replace treatment for a first episode of Graves’ disease. Eur Thyroid J. Published 2 April 2025. doi:10.
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