Drug discontinuation after treatment with minimum maintenance dose of an antithyroid drug in Graves’ disease: a retrospective study on effects of treatment duration with minimum maintenance dose on lasting remission

According to the guideline issued by the Japan Thyroid Association in 2006 for treatment of Graves’ disease, discontinuing antithyroid drug (ATD) therapy is recommended when serum free thyroxine (FT4) and thyroid stimulating hormone (TSH) concentrations have been maintained within the reference rang...

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Veröffentlicht in:Endocrine Journal 2011, Vol.58(2), pp.95-100
Hauptverfasser: Konishi, Toshiaki, Okamoto, Yasuyuki, Ueda, Miki, Fukuda, Yoshiko, Harusato, Ichiko, Tsukamoto, Yuka, Hamada, Noboru
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container_issue 2
container_start_page 95
container_title Endocrine Journal
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creator Konishi, Toshiaki
Okamoto, Yasuyuki
Ueda, Miki
Fukuda, Yoshiko
Harusato, Ichiko
Tsukamoto, Yuka
Hamada, Noboru
description According to the guideline issued by the Japan Thyroid Association in 2006 for treatment of Graves’ disease, discontinuing antithyroid drug (ATD) therapy is recommended when serum free thyroxine (FT4) and thyroid stimulating hormone (TSH) concentrations have been maintained within the reference range for a certain period after treatment with one ATD tablet every other day (minimum maintenance dose therapy, MMDT). In this retrospective study, the relationship between MMDT duration and remission rate was investigated. The participants were 107 consecutive patients with Graves’ disease whose ATD therapy was stopped according to the guideline. Serum FT4, TSH, and TSH receptor antibody (TRAb) levels were measured when ATD was discontinued and every 3 months thereafter. The percentage of patients in remission was 86.9% at 6 months, 73.8% at 1 year, and 68.2% at 2 years after ATD discontinuation. The remission rate increased with MMDT duration, being significantly higher in patients with MMDT durations of 19 months or more than those with MMDT durations of 6 months or less. In patients with MMDT durations of 6 months or less, the remission rate was significantly lower in TRAb-positive patients than in TRAb-negative patients at the time of withdrawal of ATD; however, this was not observed in patients with MMDT durations of 7 months or more. These findings suggest that in patients who discontinue ATD after a certain MMDT duration, the remission rate increases as the MMDT duration increases, and ATD should not be discontinued in TRAb-positive patients with MMDT durations of 6 months or less.
doi_str_mv 10.1507/endocrj.K10E-262
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subjects Adolescent
Aged
Antithyroid Agents - administration & dosage
Antithyroid drug treatment
Drug discontinuation
Female
Graves Disease - blood
Graves Disease - drug therapy
Graves Disease - pathology
Graves’ disease
Humans
Immunoglobulins, Thyroid-Stimulating - blood
Japan
Male
Methimazole - administration & dosage
Middle Aged
Propylthiouracil - administration & dosage
Recurrence
Remission Induction - methods
Remission rate
Retrospective Studies
Thyroid Gland - pathology
Thyrotropin - blood
Thyroxine - blood
Time Factors
Treatment Outcome
TSH receptor antibody
title Drug discontinuation after treatment with minimum maintenance dose of an antithyroid drug in Graves’ disease: a retrospective study on effects of treatment duration with minimum maintenance dose on lasting remission
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