Trusted Resources: Evidence & Education
Scientific literature and patient education texts
Thyrotropin Receptor Antibody Levels at Diagnosis and After Thionamide Course Predict Graves’ Disease Relapse
source: Thyroid : Official Journal of the American Thyroid Association
year: 2016
authors: Tun NN, Beckett G, Zammitt NN, Strachan MW, Seckl JR, Gibb FW
summary/abstract:Background:
Thionamides are associated with a high risk of recurrence following cessation. Thyrotropin receptor-stimulating antibody (TRAb) levels at diagnosis and/or after thionamides may be biomarkers of this risk. This study assesses the natural history of Graves’ thyrotoxicosis following thionamide withdrawal and factors that predict recurrence, particularly TRAb levels at diagnosis and cessation.
Methods:
An observational study was conducted of patients with a first presentation of Graves’ disease, who were prescribed (and completed) a course of primary thionamide treatment (n = 266) in a university teaching hospital endocrine clinic. Recurrence rates over four years and factors predictive of recurrent thyrotoxicosis were assessed.
Results:
The relapse rate was 31% at one year and 70% at four years. Younger age (39 years [range 30-49 years] vs. 47 years [range 37-53 years]; p = 0.011), higher TRAb levels at diagnosis (8.8 IU/L [range 5.3-17.0 IU/L] vs. 5.7 IU/L [range 4.1-9.1 IU/L]; p = 0.003), and higher TRAb levels at cessation of therapy (1.2 IU/L [range 0-2.3 IU/L] vs. <0.9 IU/L [range 0-1.3 IU/L]; p = 0.003) were associated with a higher risk of relapse. By four years, cessation TRAb <0.9 IU/L was associated with a 58% risk of recurrence compared with 82% with TRAb >1.5 IU/L (p = 0.001). TRAb at diagnosis >12 IU/L was associated with an 84% risk of recurrence over four years compared with 57% with TRAbs <5 IU/L (p = 0.002).
Conclusion:
High TRAb at diagnosis and/or positive TRAb at cessation of therapy suggest a high likelihood of relapse, mostly within the first two years. They stratify patients likely to need definitive therapy (radioiodine or surgery).
DOI: 10.1089/thy.2016.0017
read more
myBinderRelated Content
-
Graves’ Disease Pharmacotherapy in Women of Reproductive AgeGraves' disease is an autoimmune disorde...
-
Effects of Treatment Modalities for Graves’ Hyperthyroidism on Graves’ Orbitopathy: A 2015 Italian Society of En...Graves’ disease is the most frequent f...
-
The Second Antithyroid Drug Treatment is Effective in Relapsed Graves’ Disease Patients: A Median 11-Year Foll...Background: Antithyroid drug (ATD) is a...
-
Advances in Treatment of Active, Moderate-To-Severe Graves’ OphthalmopathyGraves' ophthalmopathy is defined as aut...
-
Relation Between Therapy for Hyperthyroidism and the Course of Graves’ OphthalmopathyBackground: The chief clinical characte...
-
Predicting Risk of Recurrent Thyrotoxicosis Following Thionamide Withdrawal in Graves’ DiseaseBackground/Aim: Thionamides are a safe ...
-
Most Patients With Graves’ Disease Treated With Antithyroid Drugs Eventually Require Additional TherapiesGraves’ disease is the most common cau...
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.
Powered by
Google