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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 |
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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) |
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| 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 |
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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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