source: American Family Physician

year: 2017

authors: Petersen J, Lin KW

Graves disease is the most common cause of hyperthyroidism in the United States. Although radioactive iodine therapy is the most commonly used treatment for Graves disease in the United States, patients in Europe and Japan are more likely to receive antithyroid medications or surgical thyroidectomy. This Cochrane review compared radioactive iodine therapy with antithyroid medications for quality-of-life outcomes, improvement or prevention of Graves ophthalmopathy, relapse rates, and cost-effectiveness. This review included two randomized controlled trials (RCTs) involving 425 adults with Graves disease across 11 Swedish outpatient care centers. Among these, 221 patients were randomized to methimazole (Tapazole) therapy for 18 months and 204 were randomized to a single dose of radioactive iodine therapy. 

The follow-up period ranged from two to 21 years after treatment completion, depending on the observed outcome. Other RCTs were excluded for reasons such as having a follow-up duration of less than two years (four RCTs), including patients who had received other treatment for Graves disease before the study intervention (one RCT), using inadequate randomization (one RCT), and examining other non-Graves thyroid disorders in the same study (one RCT).

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