Outcomes of Patients With Graves Disease 25 Years After Initiating Antithyroid Drug Therapy
Authors' conclusion
Careful lifelong monitoring is indicated to detect recurrence, hypothyroidism, and other autoimmune diseases. Long-term ATD treatment emerges as a beneficial first-line treatment option, especially in patients with young age at onset or presence of TED.
Study context
- Population
- Graves disease (GD) patients who participated in a randomized trial from 1997 to 2001, followed 25 years after initiating antithyroid drug treatment83% (182/218) of original trial
- Participants
- 182 patients
- Outcome
- Outcomes in GD: disease course, clinical and biochemical predictors of relapse, and quality of life
- Follow-up
- 25 years after initiating antithyroid drug treatment
Methodological detailslong-term follow-up of a randomized trial (1997–2001), biobank inflammatory biomarkers compared with age- and sex-matched healthy individuals
- Long-term follow-up of a randomized trial (1997–2001)
- Biobank inflammatory biomarkers compared with age- and sex-matched healthy individuals
Main finding
As reported in the abstract
Thyroid status at end of follow-up
- Normal thyroid function
- 34%
- Active disease
- 1%
- Spontaneous hypothyroidism
- 13%
- Ablative treatment with radioiodine
- 40%
- Thyroidectomy
- 13%
Observational data: associations, not effects.
Further findings
Predictors of relapsing disease
- Age ≤40 years, OR
- 3.22
- Thyroid eye disease (TED), OR
- 2.26
- Smoking, OR
- 2.21
- Elevated interleukin 6, OR
- 1.99
- Elevated TNFRS9, OR
- 2.36
CD40 at end of treatment
- CD40 lower in patients who maintained normal thyroid function
- P = 0.04
Autoimmune diseases · end of follow-up
- One or more autoimmune diseases
- 47%
- Vitamin B12 deficiency
- 26%
- Rheumatoid arthritis
- 5%
Quality of life
- GD patients who developed hypothyroidism had reduced quality of life
Original publication
Outcomes of Patients With Graves Disease 25 Years After Initiating Antithyroid Drug Therapy. J Clin Endocrinol Metab. Published 25 September 2023. doi:10.
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