Relapse of hyperthyroidism in Graves’ disease after long-term drug treatment

Emese Mezosi; Orsolya Nemes; Beata Bodis; Zsuzsanna Nagy; Beata Ruzsa; Karoly Rucz; Laszlo Bajnok

P472

Prev Next

Section Contents Cite

Endocrine Abstracts (2007) 14 P472

ECE2007 Poster Presentations (1) (659 abstracts)

Relapse of hyperthyroidism in Graves’ disease after long-term drug treatment

Emese Mezosi , Orsolya Nemes , Beata Bodis , Zsuzsanna Nagy , Beata Ruzsa , Karoly Rucz & Laszlo Bajnok

Views

Author affiliations

University of Pecs, School of Medicine, Pecs, Hungary.

The optimal treatment of hyperthyroidism in Graves’ disease is still an unresolved question. Hyperthyroidism recurs in 50% of patients after discontinuation of antithyroid therapy. In this retrospective study, Graves’ patients investigated in the endocrine unit of Pecs University between December 2004 and October 2006 were enrolled (68 women, 22 men, age 47 (15–79) years). Antithyroid drug therapy was applied for a minimum of one year and the treatment was withdrawn for at least 5 months. The duration of antithyroid therapy was much longer than usually recommended, on the average 3,4 years, the median follow up was 20 months. The relapse rate in the group of patients treated over two years (on the average 4,6 years) was even higher (59%) than in the group treated for 1–2 years (50%) (P=0.008). Predictors of the relapse were age<40 years at the onset of disease, enlarged thyroid gland, positive TSH-receptor antibody (TRAK) level, other autoimmune disease, endocrine orbitopathy and thiamazole allergy. The relapse rate was lower after block-replace treatment regimen (40% versus 64%, P<0.001). Recurrence of hyperthyroidism was more frequent in women (58%) than in men (45%, P<0.001). The nodularity of the thyroid gland and the negative TRAK level did not affect the recurrence of thyrotoxicosis. In conclusion, long-term (over two years) treatment of Graves’ disease did not decrease the risk for relapse after discontinuation of drug therapy.