Trusted Resources: Evidence & Education
Scientific literature and patient education texts
External Validation of the GREAT Score to Predict Relapse Risk in Graves’ Disease: Results from a Multicenter, Retrospective Study With 741 Patients
source: European Journal of Endocrinology / European Federation of Endocrine Societies
year: 2017
authors: Struja T, Kaeslin M, Boesiger F, Jutzi R, Imahorn N, Kutz A, Bernasconi L, Mundwiler E, Mueller B, Christ-Crain M, Meienberg F, Ebrahimi F, Henzen C, Fischli S, Kraenzlin M, Meier C, Schuetz P
summary/abstract:Context:
First-line treatment in Graves’ disease is often done with antithyroid agents (ATD), but relapse rates remain high making definite treatment necessary. Predictors for relapse risk help guiding initial treatment decisions.
Objective:
We aimed to externally validate the prognostic accuracy of the recently proposed Graves’ Recurrent Events after Therapy (GREAT) score to predict relapse risk in Graves’ disease.
Design, Setting and Participants:
We retrospectively analyzed data (2004-2014) of patients with a first episode of Graves’ hyperthyroidism from four Swiss endocrine outpatient clinics.
Main Outcome Measures:
Relapse of hyperthyroidism analyzed by multivariate Cox regression.
Results:
Of the 741 included patients, 371 experienced a relapse (50.1%) after a mean follow-up of 25.6 months after ATD start. In univariate regression analysis, higher serum free T4, higher thyrotropin-binding inhibitor immunoglobulin (TBII), younger age and larger goiter were associated with higher relapse risk. We found a strong increase in relapse risk with more points in the GREAT score from 33.8% in patients with GREAT class I (0-1 points), 59.4% in class II (2-3 points) with a hazard ratio of 1.79 (95% CI: 1.42-2.27, P < 0.001) and 73.6% in class III (4-6 points) with a hazard ratio of 2.24 (95% CI: 1.64-3.06, P < 0.001).
Conclusions:
Based on this retrospective analysis within a large patient population from a multicenter study, the GREAT score shows good external validity and can be used for assessing the risk for relapse in Graves’ disease, which influence the initial treatment decisions.
DOI: 10.1530/EJE-16-0986
read more full text
Related Content
-
Graves’ Disease in a Newborn (Neonatal Graves’ Disease)What is Graves Disease in a Newborn? Gr...
-
Graves’ Disease Treatment for Someone in Their 20sHyperthyroidism triggered by Graves’ d...
-
A Prospective Study of the Effects of Radioiodine Therapy for Hyperthyroidism in Patients With Minimally Active Grav...Context: Radioiodine is an effective an...
-
N. Scott Adzick, MD, MMM, FACS, FAAPDr. Adzick is the C. Everett Koop Profes...
-
A Second Course of Antithyroid Drug Therapy for Recurrent Graves’ Disease: An Experience in Endocrine PracticeObjective: There are scarce reports reg...
-
Thyroid StormThyroid storm is a very rare, but life-t...
-
Radioactive Iodine Can Be First-Line for Hyperthyroidism, Says UKNew UK guidelines for the treatment of h...
To improve your experience on this site, we use cookies. This includes cookies essential for the basic functioning of our website, cookies for analytics purposes, and cookies enabling us to personalize site content. By clicking on 'Accept' or any content on this site, you agree that cookies can be placed. You may adjust your browser's cookie settings to suit your preferences. More Information
The cookie settings on this website are set to "allow cookies" to give you the best browsing experience possible. If you continue to use this website without changing your cookie settings or you click "Accept" below then you are consenting to this.