Tags

Type your tag names separated by a space and hit enter

Treatment of Graves' disease: effects of the administration of L-thyroxine associated with methimazole as a single daily dose.
Eur J Med. 1993 Feb; 2(2):70-4.EJ

Abstract

OBJECTIVES

To reduce the number of tablets to be administered daily during antithyroid drug (ATD) treatment of Graves' disease (GD) and to evaluate the effectiveness of adding thyroxine after the patients had become euthyroid during methimazole therapy.

PATIENTS AND METHODS

All patients were given gelatin capsules with 30 mg of methimazole 2 times per day for 4-6 weeks, followed by two capsules with 20 mg of methimazole and 75 micrograms of thyroxine to be taken once a day for 18-24 months. Thirty patients with Graves' disease without previous treatment for hyperthyroidism were included. Two were lost to follow-up and 28 (24 women and 4 men; age range 14-53 years; mean 34.2 years) were followed for 18 to 24 months with methimazole and thyroxine medication plus an additional 2 years after the treatment was suspended. After completion of the study the patients were, retrospectively, divided in two groups: group 1 (G1, n = 20) patients considered to be in remission, and group 2 (G2, n = 8) with persistent active Graves' disease.

RESULTS

All patients in group 1 had a significant reduction in the glandular mass, as estimated by ultrasonographic studies (mean +/- SD 67 +/- 13 g to 18 +/- 3 g, p < 0.01) whereas subjects in group 2 had no significant reduction in glandular mass (67 +/- 14 g to 53 +/- 16 g). Thyroglobulin levels (mean +/- SD) in G1 were 54 +/- 55 micrograms/L at baseline and decreased to 15 +/- 9 micrograms/L (p < 0.001), and in G2 thyroglobulin concentrations did not decrease significantly after therapy (58 +/- 20 micrograms/L vs 44 +/- 22 micrograms/L). Also, levels of thyroid-stimulating hormone receptor inhibiting antibody (TRAb) only decreased in G1 (49-21% to 8 +/- 5%; p < 0.001). Nineteen patients (all from G1), were euthyroid 2 years after treatment withdrawal, indicating a remission rate of 67.8%.

CONCLUSION

The administration of L-thyroxine during anti-thyroid drug treatment, with subsequent inhibition of thyroid-stimulating hormone secretion, may be an important factor in glandular mass reduction, decreasing both the production of antibodies to thyroid-stimulating hormone receptors and the frequency of recurrence of hyperthyroidism.

Authors+Show Affiliations

Thyroid Laboratory, Hospital das Clínicas, University of Sao Paulo Medical School, Brazil.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8258020

Citation

Perozim, L M., et al. "Treatment of Graves' Disease: Effects of the Administration of L-thyroxine Associated With Methimazole as a Single Daily Dose." The European Journal of Medicine, vol. 2, no. 2, 1993, pp. 70-4.
Perozim LM, Lima N, Knobel M, et al. Treatment of Graves' disease: effects of the administration of L-thyroxine associated with methimazole as a single daily dose. Eur J Med. 1993;2(2):70-4.
Perozim, L. M., Lima, N., Knobel, M., Cavaliere, H., & Medeiros-Neto, G. (1993). Treatment of Graves' disease: effects of the administration of L-thyroxine associated with methimazole as a single daily dose. The European Journal of Medicine, 2(2), 70-4.
Perozim LM, et al. Treatment of Graves' Disease: Effects of the Administration of L-thyroxine Associated With Methimazole as a Single Daily Dose. Eur J Med. 1993;2(2):70-4. PubMed PMID: 8258020.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of Graves' disease: effects of the administration of L-thyroxine associated with methimazole as a single daily dose. AU - Perozim,L M, AU - Lima,N, AU - Knobel,M, AU - Cavaliere,H, AU - Medeiros-Neto,G, PY - 1993/2/1/pubmed PY - 1993/2/1/medline PY - 1993/2/1/entrez SP - 70 EP - 4 JF - The European journal of medicine JO - Eur J Med VL - 2 IS - 2 N2 - OBJECTIVES: To reduce the number of tablets to be administered daily during antithyroid drug (ATD) treatment of Graves' disease (GD) and to evaluate the effectiveness of adding thyroxine after the patients had become euthyroid during methimazole therapy. PATIENTS AND METHODS: All patients were given gelatin capsules with 30 mg of methimazole 2 times per day for 4-6 weeks, followed by two capsules with 20 mg of methimazole and 75 micrograms of thyroxine to be taken once a day for 18-24 months. Thirty patients with Graves' disease without previous treatment for hyperthyroidism were included. Two were lost to follow-up and 28 (24 women and 4 men; age range 14-53 years; mean 34.2 years) were followed for 18 to 24 months with methimazole and thyroxine medication plus an additional 2 years after the treatment was suspended. After completion of the study the patients were, retrospectively, divided in two groups: group 1 (G1, n = 20) patients considered to be in remission, and group 2 (G2, n = 8) with persistent active Graves' disease. RESULTS: All patients in group 1 had a significant reduction in the glandular mass, as estimated by ultrasonographic studies (mean +/- SD 67 +/- 13 g to 18 +/- 3 g, p < 0.01) whereas subjects in group 2 had no significant reduction in glandular mass (67 +/- 14 g to 53 +/- 16 g). Thyroglobulin levels (mean +/- SD) in G1 were 54 +/- 55 micrograms/L at baseline and decreased to 15 +/- 9 micrograms/L (p < 0.001), and in G2 thyroglobulin concentrations did not decrease significantly after therapy (58 +/- 20 micrograms/L vs 44 +/- 22 micrograms/L). Also, levels of thyroid-stimulating hormone receptor inhibiting antibody (TRAb) only decreased in G1 (49-21% to 8 +/- 5%; p < 0.001). Nineteen patients (all from G1), were euthyroid 2 years after treatment withdrawal, indicating a remission rate of 67.8%. CONCLUSION: The administration of L-thyroxine during anti-thyroid drug treatment, with subsequent inhibition of thyroid-stimulating hormone secretion, may be an important factor in glandular mass reduction, decreasing both the production of antibodies to thyroid-stimulating hormone receptors and the frequency of recurrence of hyperthyroidism. SN - 1165-0478 UR - https://www.unboundmedicine.com/medline/citation/8258020/Treatment_of_Graves'_disease:_effects_of_the_administration_of_L_thyroxine_associated_with_methimazole_as_a_single_daily_dose_ DB - PRIME DP - Unbound Medicine ER -