Recent advances in management of Graves' disease: an update

Treatment of Graves' disease (GD) is complex and controversial. Conventional therapy of GD includes antithyroid drugs (ATDs), surgery, and radio-iodine therapy (RIT) and each has limitations. ATDs are associated with high rates of relapse and side effects. Definitive therapies result in permanent hypothyroidism and increased risk of Graves' ophthalmopathy. With advancements in the understanding of precise autoimmune mechanisms causing GD, novel therapies targeting immune pathways are in the pipeline of development. Newer drugs switch off a part of the immune system that is causing the disease, leaving the rest of the immune system still functioning. Though newer drugs seem to be efficacious, they may elicit higher incidence of infection and other side effects. Other concerns with newer drugs are that they may not be able to cure the disease, do not achieve adequate effectiveness in all patients, and may not achieve remission in all patients. Therefore, additional newer drugs will be needed in future.