HIGH THYROPEROXIDASE ANTIBODY TITERS MAY PREDICT RESPONSE TO ANTITHYROID DRUG TREATMENT IN GRAVES DISEASE: A...

Area of Science:

• Endocrinology
• Immunology

Background:

• Graves hyperthyroidism is commonly treated with antithyroid drugs (ATD).
• Remission rates with ATD range from 40-50% within 12-18 months, sometimes extending to 24 months.
• Predicting ATD response is crucial for optimizing patient management.

Purpose of the Study:

• To evaluate clinical and biochemical variables, including the GREAT score, for predicting ATD response in Graves disease.
• To identify factors associated with successful medical treatment.

Main Methods:

• Retrospective single-center study of 99 patients with newly diagnosed Graves disease.
• Patients received ATD for at least 18 months.
• Group 1: Responded to ATD at 18-24 months. Group 2: Did not respond and continued low-dose ATD.

Main Results:

• 38.3% responded at 18 months, 19.1% at 24 months.
• Higher thyroid volume, free T4, and more frequent orbitopathy were observed in non-responders (Group 2).
• Significantly higher median anti-thyroid peroxidase (anti-TPO) antibody titers in responders (Group 1: 593 U/l vs. Group 2: 191.6 U/l).
• GREAT class 3 was more prevalent in non-responders (46.5% vs. 12.5%).
• Highest anti-TPO antibody levels were significantly associated with a positive response to ATD within 24 months (p <0.05).

Conclusions:

• The GREAT score and baseline anti-TPO antibody titers can aid in predicting ATD response in Graves disease.
• These markers may help personalize treatment strategies for hyperthyroidism.