Journal of Regional Section of Serbian Medical Association in Zajecar

Year 2014     Vol 39     No 4
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      UDK 616.441-008.61-085 ; 615.252.44.06 ; 615.849.2:546.15

ISSN 035-2899, 39(2014) br.4 p.164-170

Original paper

Unfavourable effect of prolonged treatment with antithyroid drugs on radioiodine therapy outcome in Graves’ hyperthyroidism
(Nepovoljan uticaj produženog lečenja antitiroidnim lekovima na ishod terapije radioaktivnim jodom kod pacijenata sa Grejvsovim hipertiroidizmom)


  Download in pdf format   Extended summary: Radioiodine therapy (RIT) of Graves’ hyperthyroidism (GH) is usually recommended after failure of primary therapy with antithyroid drugs (ATDs), which are commonly prescribed for up to 18-24 months. However, in our region, the prolonged ATDs treatment of the disease is very common. Thus, we assessed the efficacy of RIT after prolonged continual pretreatment with ATDs in Graves’ hyperthyroidism. Therapy outcome using a single dose of radioiodine was evaluated after one year in 91 patients (f/m: 73/18, age: 50.2±10.9 yr). According to ATDs pretreatment duration, the patients were classified into: 1st group <2 yr, 2nd group 2-3 yr and 3rd group >3 yr. In relation to RIT outcome, the patients were estimated as cured (euthyroid or hypothyroid) or non-cured (hyperthyroid). Overall, after one year of follow-up, 52.7% patients were cured with one dose of radioiodine. Comparing mean values of patients’ age and TSH serum levels at time of RIT as well as radioiodine dose betwen cured and non-cured patients of the whole population of patients, significant differences have not been observed. However, non-cured patients were significantly longer pretreated with ATDs (p<0.005). The ratio between the cured and non-cured patients was 73.9% vs. 26.1% in the first group (p<0.0001), 65.5% vs. 34.5% in the second (p <0.001) and 30.8% vs. 69.2% in the third group (p<0.0001). There was no significant difference in radioiodine dose, duration of ATDs pretreatment, TSH levels and patients’ age between cured and non-cured patients in each group, although non-cured patients from the third group were somewhat older (p=0.085). Among the cured patients who were <50 or ≥50 yr of age, a significant difference was found only in the third group (a smaller percent of patients were ≥50 years old). The results of this study suggest that prolongation of ATDs pretreatment of Graves’ hyperthyroidism over two years should not be allowed because of their unfavourable effect on radioiodine therapy outcome. Nevertheless, if a patient has been treats much longer, especially if he/she is ≥ 50 years of age, administration of higher doses of radioiodine may be recommended in order to achieve a better outcome.
Keywords: Graves’ hyperthyroidism, antithyroid drugs, radioiodine therapy

Napomena: kompletan tekst rada na srpskom jeziku
Note: full text in Serbian
      Corresponding Address:
Milena Rajić
Centar za nuklearnu medicinu, Klinički Centar Niš, Bul. dr Zorana Đinđića 48; 18 000 Niš, Srbija
Paper received: 31.7.2014
Paper accepted: 1.8.2014
Paper Internet issues: 17.11.2014
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Timočki medicinski glasnik, Zdravstveni centar Zaječar
Journal of Regional section of Serbian medical association in Zajecar
Rasadnička bb, 19000 Zaječar, Srbija

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