Ten Year Outcome of Anti‐Thyroid Drug Treatment for First Episode Graves' Thyrotoxicosis: The Predictive Importance of TSH Receptor Antibody (TRAb)
Authors' conclusion
Most recurrent thyrotoxicosis occurs within the first few years after ATD withdrawal. TRAb concentration, at diagnosis and cessation of ATD, is a useful predictor of recurrence risk and can be used to inform decisions on the optimal approach to primary therapy.
Study context
- Population
- People with a first episode of Graves' thyrotoxicosis who completed a course of anti-thyroid drugs (ATD)
- Participants
- 290 people
- Exposure
- Relapse vs no relapse after ATD withdrawal
- Outcome
- Recurrent thyrotoxicosis after ATD withdrawal
- Follow-up
- 10 years
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Recurrence over 10 years
54%
Recurrences occurring within 2 years
73%
Observational data: associations, not effects.
Further findings
Age · younger age associated with relapse
P = 0.011
TRAb at diagnosis · higher TRAb associated with relapse
P = 0.002
Time to normalisation of TSH · longer time associated with relapse
p 0.013
Time to normalisation of FT4 · longer time associated with relapse
P = 0.001
| Outcome | Relapse | No relapse | P value |
|---|---|---|---|
| TRAb at cessation of ATDHigher TRAb associated with relapse | 1.3 (range <0.9-2.3) | 1.0 (range <0.9-1.3) | P < 0.001 |
Recurrence within 10 years by TRAb at diagnosis
- TRAb > 12 IU/L at diagnosis
- 74%
- TRAb < 5 IU/L at diagnosis
- 44%
- P
- P = 0.001
Multivariate analysis
- TRAb (at diagnosis and cessation) and age independently associated with relapse
Original publication
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