Radioactive Iodine Therapy of Graves’ Disease in Patients Pretreated With Methimazole Without Radioiodine Uptake for Dose Estimation
Main finding · Response to RAI therapyResult — go to the resultHazard ratio 3.18 95% CI 1.1–9.7Authors' conclusion
RAI therapy for Graves' disease without uptake studies for dose estimates is an effective treatment method. In patients pretreated with methimazole, an RAI dose per gram of thyroid tissue of ≥14.8 MBq (0.4 mCi) showed high response rate. Prospective studies are needed to confirm the viability of this simplified and cost-effective approach.
Study context
- Population
- Patients with GD pretreated with methimazole, given radioactive iodine (RAI) doses determined without uptake studies; median age 41.9 years, 66.1% female
- Participants
- 242 patients
- Exposure
- RAI dose per gram of thyroid tissue ≥14.8 MBq vs lower
- Outcome
- Response to RAI therapy (hypothyroid or euthyroid)
Main finding
Response to RAI therapy
Hazard ratio
3.18
95% CI 1.1–9.7
≥14.8 MBq/gvs <14.8 MBq/g
HR 3.18 (95% CI 1.1–9.7)
As reported in the abstract
- Responded to RAI therapy
- 208 (85.9%)
- Became hypothyroid
- 185 (88.9%)
- Became euthyroid
- 23 (11.1%)
Observational data: associations, not effects.
Further findings
Time to response
- Time to response — Responded within 6 months of therapy
- 90.4%
Nonresponders
- 34 nonresponders had higher initial free thyroxine (FT4), larger thyroid size and lower RAI dose per gram of thyroid tissue
Original publication
Radioactive Iodine Therapy of Graves’ Disease in Patients Pretreated With Methimazole Without Radioiodine Uptake for Dose Estimation. Endocr Pract. Published 1 February 2024. doi:10.
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