The Two-Year Results of Using Radiofrequency Ablation as a Novel Treatment for Persistent or Relapsed Graves’ Disease: A Prospective Study
Authors' conclusion
In a highly selected group of patients with relapsed GD and predominantly small thyroid glands, single-session RFA may achieve disease remission. Smaller total thyroid volume may be a favorable factor associated with disease remission after RFA.
Study context
- Population
- Patients aged ≥18 with persistent/relapsed graves' disease (GD) requiring antithyroid drugs; excluded compressive goiter, suspected malignancy, moderate-to-severe Graves' ophthalmopathy, preference for surgery/RAI, pregnancy; 93.3% female; median total thyroid volume 23 mL100 considered
- Participants
- 30 patients
- Outcome
- Disease remission rate (biochemically euthyroid or hypothyroid without antithyroid drugs) after single-session RFA
- Follow-up
- 24 months
Methodological detailstwo tertiary endocrine surgery centres, consecutive patients
- Two tertiary endocrine surgery centres
- Consecutive patients
Main finding
As reported in the abstract
Disease remission rate
Radiofrequency ablation (RFA)
56.7%
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Values | P value |
|---|---|---|
| Disease remission rate · 12 months | RFA 60.0% | |
| Disease remission by total thyroid volume · 24 monthsTotal thyroid volume <20 mL vs Total thyroid volume ≥20 mL | Total thyroid volume <20 mL 100% · Total thyroid volume ≥20 mL 35% | P = 0.007 |
- Disease remission by total thyroid volume: 9 patients with volume <20 mL
Relapse after RFA
- Patients with relapse after RFA
- 13
- Relapsed patients requiring a lower antithyroid drug dose than before RFA
- 9 (69%)
- Relapsed patients who received surgery without complications
- 2
Total thyroid volume as factor associated with relapse after RFA
- OR for relapse per total thyroid volume (only significant factor), CI 1.012-1.099, p = 0.012
- 1.054
Safety
- No vocal cord palsy, skin burn, hematoma or thyroid storm after RFA
- 2 relapsed patients received surgery without complications
Original publication
The Two-Year Results of Using Radiofrequency Ablation as a Novel Treatment for Persistent or Relapsed Graves’ Disease: A Prospective Study. Thyroid. Published 3 July 2024. doi:10.
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