Antithyroid drugs in the treatment of hyperthyroidism of Graves' disease: long-term follow-up of 434 patients. Scottish Automated Follow-Up Register Group

Clin Endocrinol (Oxf). 1989 Aug;31(2):209-18. doi: 10.1111/j.1365-2265.1989.tb01244.x.

Abstract

A study of antithyroid drug (ATD) therapy with a mean follow-up period of 10 years (range 2-25) in 434 patients with Graves' disease has been made by linking hospital records with those of a central follow-up register. The majority (89%) were treated with carbimazole and 87% received combined therapy with triiodothyronine (T3) (73%) or thyroxine (T4) (14%). Sixty-one per cent were assessed for T3 suppression tests on completion of treatment, of whom 61% (95% CL, 55-67%) suppressed. The overall 5-year cumulative proportion developing recurrent hyperthyroidism was 54-62% with rates of 26-44% in suppressed patients and 65-79% in those not suppressed. In unsuppressed patients, most (72%) of the recurrences occurred within 1 year with only an additional 10% predicted up to 10 years. In suppressed patients 30% of recurrences occurred in the first year, 60% between 1 and 5 years and a further 10% between 5 and 10 years. Suppression with T3 is probably the best and cheapest predictor of outcome but has an accuracy of only 70% for both positive and negative tests which limits its usefulness in planning long-term follow-up and surveillance. A standard format should be adopted for the analysis and reporting of follow-up studies, based on actuarial methods of estimating the cumulative proportion with recurrences or other events, to facilitate comparisons between different centres.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antithyroid Agents / adverse effects
  • Antithyroid Agents / analysis
  • Antithyroid Agents / therapeutic use*
  • Female
  • Follow-Up Studies
  • Graves Disease / drug therapy*
  • Graves Disease / epidemiology
  • Humans
  • Hyperthyroidism / drug therapy*
  • Hyperthyroidism / epidemiology
  • Male
  • Middle Aged
  • Recurrence
  • Time Factors

Substances

  • Antithyroid Agents