Endocrine Abstracts

Objective: We aim of the study was to investigate the clinical approach to Graves’ disease (GD) treatment among endocrinologists in Russia.

Materials and methods: An online questionnaire survey was conducted among doctors from Sept till Dec 2021. The questions covered the principles of diagnosis, treatment and dynamic observation of adults with GD.

Results: 104 endocrinologists participated in the study. 99% of respondents chose the thyrotropin receptor antibody (TRAb) test to clarify the etiology of thyrotoxicosis, while 60.6% chose thyroid scintigraphy. Antithyroid drug (ATD) treatment was chosen as the first-line treatment by 88.5% of responders, radioactive iodine (RAI) by 13.5%. Titration ATD regimen is preferable compared to the "block-replace" 72.1% vs 28.8%. Most doctors (95.2%) initiate therapy with moderate doses of thiamazole (20-30 mg). Most of them perform dynamic monitoring of the level of transaminases (57.7%) and complete blood count (78.8%). ATD treatment is prescribed for a period of 12-18 months by 88.5% of doctors, up to 24 months by 10.6%. 89.4% of respondents monitor thyroid hormones, 82.7% of respondents TRAb and 49% perform thyroid ultrasound before ATD withdrawal. Repeated courses of ATD treatment are prescribed by up to 61.5% of respondents. About 63.5% of the surveyed doctors stated difficulties with referral to radical treatment due to the limited number of specialized institutions. The main limiting factors in RAI are the patient’s unwillingness and planning pregnancy (81.6% and 24.3%, respectively); thyroidectomy is associated with patient unwillingness (69.2%), as well as doctors’ fear of developing complications (49%).

Conclusion: The results of the study demonstrated that in their practice, doctors, as a rule, follow international recommendations for the treatment of GD. This study is unique in its kind, since no similar work has been carried out in Russia before.