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Antithyroid drug regimen for treating Graves' hyperthyroidism.
P Abraham1, A Avenell, W A Watson
1Endocrinology, University of Aberdeen, Ward 27/28, Aberdeen Royal Infirmary, Aberdeen, Scotland, UK, AB25 2ZN.
The Cochrane Database of Systematic Reviews
|October 30, 2003
Summary
For Graves' hyperthyroidism, antithyroid drug therapy duration of 12-18 months is optimal for the titration regimen. The block-replace regimen showed similar efficacy but more side effects than the titration regimen.
Area of Science:
- Endocrinology
- Pharmacology
Background:
- Antithyroid drugs are standard treatment for hyperthyroidism.
- Significant variability exists in prescribed antithyroid drug doses, regimens, and treatment durations.
Purpose of the Study:
- To evaluate the impact of antithyroid drug dose, regimen, and duration on Graves' hyperthyroidism treatment outcomes.
- To compare the efficacy and safety of different antithyroid drug therapy approaches.
Main Methods:
- Systematic review and meta-analysis of randomized and quasi-randomized controlled trials.
- Searched multiple databases including Cochrane Central Register, MEDLINE, EMBASE, and others up to June 2002.
- Data extraction and quality assessment performed independently by two reviewers.
Main Results:
- Nineteen trials with 2233 participants were included; trial quality was generally poor.
- Longer titration therapy (18 months) reduced relapse rates compared to 6 months (OR=0.42).
- Block-replace regimens had higher rates of rashes and withdrawals due to side effects compared to titration regimens.
Conclusions:
- Optimal duration for the titration regimen appears to be 12-18 months.
- The block-replace regimen showed similar efficacy to the titration regimen but with more adverse effects.
- No significant difference was observed when adding thyroxine post-antithyroid drug therapy.