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The effect of combination therapy with propylthiouracil and cholestyramine in the treatment of Graves' hyperthyroidism.
Clin Endocrinol (Oxf). 2005 May; 62(5):521-4.CE

Abstract

OBJECTIVE

The study aims to evaluate the efficacy of combination therapy with propylthiouracil (PTU) and cholestyramine in the treatment of Graves' hyperthyroidism.

BACKGROUND

Thyroxine (T4) is metabolized mainly in the liver by conjugation to glucuronides and sulphates that enter the enterohepatic circulation. Thyrotoxic patients have an abnormal increase in thyroid hormone in their enterohepatic circulation. Previous studies on combination therapy with methimazole and cholestyramine for Graves' hyperthyroidism have shown it to be an effective adjunctive treatment. In this study, we examined the efficacy of combination therapy with PTU and cholestyramine in the treatment of Graves' hyperthyroidism.

METHODS

Thirty patients with newly diagnosed Graves' hyperthyroidism were randomly divided into two groups: group I (n = 15) received PTU 100 mg twice a day, propranolol 40 mg twice a day and cholestyramine 4 g twice a day for 4 weeks; group II (n = 15) received PTU 100 mg twice a day and propranolol 40 mg twice a day for 4 weeks. The therapeutic efficacy was determined by serum total triiodothyronine (TT3), free thyroxine (FT4) and TRAb levels at baseline, and at the end of 2 and 4 weeks during the study period.

RESULTS

There was no significant difference in baseline thyroid function parameters. At the end of 2 and 4 weeks of the study period, serum TT3 and FT4 levels of group I were significantly lower than those of group II. No significant differences in the TRAb level were found between the two groups.

CONCLUSION

Cholestyramine contributed to a more rapid and complete decline in thyroid hormone levels in patients with Graves' hyperthyroidism. It was thus proved to be an effective and well-tolerated adjunctive therapy.

Authors+Show Affiliations

Division of Endocrinology and Metabolism, Department of Internal Medicine, Buddhist Tzu-Chi General Hospital, Tzu-Chi University, Hualien, Taiwan, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

15853819

Citation

Tsai, Wen-Chin, et al. "The Effect of Combination Therapy With Propylthiouracil and Cholestyramine in the Treatment of Graves' Hyperthyroidism." Clinical Endocrinology, vol. 62, no. 5, 2005, pp. 521-4.
Tsai WC, Pei D, Wang TF, et al. The effect of combination therapy with propylthiouracil and cholestyramine in the treatment of Graves' hyperthyroidism. Clin Endocrinol (Oxf). 2005;62(5):521-4.
Tsai, W. C., Pei, D., Wang, T. F., Wu, D. A., Li, J. C., Wei, C. L., Lee, C. H., Chen, S. P., & Kuo, S. W. (2005). The effect of combination therapy with propylthiouracil and cholestyramine in the treatment of Graves' hyperthyroidism. Clinical Endocrinology, 62(5), 521-4.
Tsai WC, et al. The Effect of Combination Therapy With Propylthiouracil and Cholestyramine in the Treatment of Graves' Hyperthyroidism. Clin Endocrinol (Oxf). 2005;62(5):521-4. PubMed PMID: 15853819.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of combination therapy with propylthiouracil and cholestyramine in the treatment of Graves' hyperthyroidism. AU - Tsai,Wen-Chin, AU - Pei,Dee, AU - Wang,Tso-Fu, AU - Wu,Du-An, AU - Li,Jer-Chuan, AU - Wei,Cheng Lian, AU - Lee,Chien-Hsing, AU - Chen,Sheng-Pyng, AU - Kuo,Shi-Wen, PY - 2005/4/28/pubmed PY - 2005/7/15/medline PY - 2005/4/28/entrez SP - 521 EP - 4 JF - Clinical endocrinology JO - Clin Endocrinol (Oxf) VL - 62 IS - 5 N2 - OBJECTIVE: The study aims to evaluate the efficacy of combination therapy with propylthiouracil (PTU) and cholestyramine in the treatment of Graves' hyperthyroidism. BACKGROUND: Thyroxine (T4) is metabolized mainly in the liver by conjugation to glucuronides and sulphates that enter the enterohepatic circulation. Thyrotoxic patients have an abnormal increase in thyroid hormone in their enterohepatic circulation. Previous studies on combination therapy with methimazole and cholestyramine for Graves' hyperthyroidism have shown it to be an effective adjunctive treatment. In this study, we examined the efficacy of combination therapy with PTU and cholestyramine in the treatment of Graves' hyperthyroidism. METHODS: Thirty patients with newly diagnosed Graves' hyperthyroidism were randomly divided into two groups: group I (n = 15) received PTU 100 mg twice a day, propranolol 40 mg twice a day and cholestyramine 4 g twice a day for 4 weeks; group II (n = 15) received PTU 100 mg twice a day and propranolol 40 mg twice a day for 4 weeks. The therapeutic efficacy was determined by serum total triiodothyronine (TT3), free thyroxine (FT4) and TRAb levels at baseline, and at the end of 2 and 4 weeks during the study period. RESULTS: There was no significant difference in baseline thyroid function parameters. At the end of 2 and 4 weeks of the study period, serum TT3 and FT4 levels of group I were significantly lower than those of group II. No significant differences in the TRAb level were found between the two groups. CONCLUSION: Cholestyramine contributed to a more rapid and complete decline in thyroid hormone levels in patients with Graves' hyperthyroidism. It was thus proved to be an effective and well-tolerated adjunctive therapy. SN - 0300-0664 UR - https://www.unboundmedicine.com/medline/citation/15853819/The_effect_of_combination_therapy_with_propylthiouracil_and_cholestyramine_in_the_treatment_of_Graves'_hyperthyroidism_ L2 - https://doi.org/10.1111/j.1365-2265.2005.02249.x DB - PRIME DP - Unbound Medicine ER -