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The Relationship between Third-generation TSH Receptor Antibody Positivity and Cumulative Methimazole Dose Used until

Serhat Ozçelik1, Mehmet Celik2, Aski Vural3

  • 1Department of Endocrinology and Metabolic Diseases, University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, Turkey.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|May 24, 2021
PubMed
Abstract

Insights

Graves' disease patients with positive TSH receptor antibody (TRAb) at diagnosis required higher cumulative methimazole doses and had longer remission times. Positive TRAb levels at diagnosis are linked to lower remission rates in Graves' disease.

Area of Science:

  • Endocrinology
  • Immunology

Background:

  • Graves' disease is an autoimmune disorder characterized by hyperthyroidism.
  • Thyroid-stimulating hormone receptor antibodies (TRAb) play a key role in the pathogenesis of Graves' disease.
  • Methimazole is a primary treatment for Graves' disease, but remission rates can vary.

Purpose of the Study:

  • To investigate the association between third-generation TRAb positivity at diagnosis and the cumulative methimazole dose required for remission in Graves' disease patients.
  • To determine if TRAb status influences the likelihood of achieving remission within a defined treatment period.

Main Methods:

  • A cross-sectional, descriptive study was conducted with newly diagnosed Graves' disease patients.
  • Patients were categorized based on TRAb status (positive/negative) at diagnosis and remission status at 18 months of methimazole treatment.
  • Comparisons were made regarding time to remission and cumulative methimazole dose between TRAb-positive and TRAb-negative groups.

Main Results:

  • The overall TRAb positivity rate was 58.5%.
  • Patients who did not achieve remission by 18 months had a statistically significant higher rate of TRAb positivity (p = 0.023).
  • TRAb-positive patients experienced longer remission times and required higher cumulative methimazole doses (p <0.001).

Conclusions:

  • Third-generation TRAb positivity at diagnosis is associated with a lower remission rate in Graves' disease patients within 18 months.
  • TRAb status is a significant predictor of treatment response and methimazole dosage requirements in Graves' disease.
  • These findings highlight the importance of TRAb testing for predicting treatment outcomes in Graves' disease.

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