Endocrine Abstracts

Objective: Radioiodine (RAI), surgical and anti-thyroid drug therapy are the main options to treat Graves’ disease (GD). The aim of this study was to investigate theurapeutic options, their efficacy and adverse reactions of prophilthiouracil (PTU) and methimazole (MMI).

Design: A total of 650 patients with GD were evaluated retrospectively. Treatments, adverse reactions, clinical and laboratory results were recorded. After 18 months of primary medical treatment, recurrence rates of MMI and PTU were compared by the following one year.

Results: Mean age was 42.2±13.6. Of the patients, %55.4 (n=360) were treated with MMI and 44.6% (n=290) with PTU. RAI and surgery treatment were applied 9.4% vs 7.4% respectively because of adverse reactions or unable to achieve euthyroidism with maximum dose of drugs or malignity suspicion. %16.6 (n=108) of patients were still continuing to take anti-thyroid treatment. 66.6% (n=433) of the patients completed 18 month-period of the therapy and %61.2 (n=256) of them were in remission by the following 1 year. Recurrence were detected in 38.8% (n=168) of the patients and they were all treated with RAI (72%) and surgery (28%). %14.6 of patients (95/650) underwent surgery. Thyroid nodules were detected in 26.3% (n=171) of the patients. Papillary thyroid cancer were detected in 9.5% (n=10). Thyroid ophthalmopathy were seen in 8.6% (n=56). Adverse reactions of drugs were found in 6.9% (n=45) (with 2.5% of skin, 2.3% of hepatotoxicity, 1.8% of temporary neutropenia, 0.6% of agranulocytosis). there were not significance difference between MMI and PTU in terms of adverse effects.

Conclusion: Remission rates of medical treatment were high although minor and major adverse drug reactions were seen in the treatment of GD. We could not detect difference in terms of advers effects of MMI and PTU. They could be used safely.