Endocrine Abstracts

Introduction: Graves’ disease is the leading cause of hyperthyroidism in the adult population. Antithyroid drugs (ATD) are the first choice worldwide, however, after an initial treatment course of 18-24 months, almost 40-50% will relapse. In these cases, current guidelines suggest a second course or prolonged use of ATD as an option. Recently, the study of quality of life (QOL) has obtained great importance, since the QOL in hyperthyroid patients is very affected. However, there are scarce data on QOL in patients after the treatment of Graves’ disease.

Objectives: The objective of the study was to evaluate the QOL using the Thy-PRO 39 questionnaire in Graves’ disease patients who relapsed after an initial ATD course and were treated with radioiodine (RAI) or a second course of ATD.

Materials and Methods: Fifty-one patients with Graves’ disease relapse were evaluated, in the euthyroid state, according to the Thy-PRO 39 questionnaire (validated for the Brazilian population) and divided according to the treatment. Group 1: patients on the second course of ATD; Group 2: patients treated with RAI followed by levothyroxine supplementation. Group 3: was represented by patients in remission.

Results: In Group 1 (n =30), mean age was 56 ± 14 years, mean serum TSH = 2.49 ± 1.66 uUI/ml, and mean serum FT4 =1.12 ± 0.25 ng/dL mean period of treatment with ATD was 75 ± 66 months, 10% of the patients were current smokers. In Group 2 (n =21), mean age was 55 ± 12 years, mean serum TSH = 2.40 ± 1.47 uUI/ml, and mean serum FT4 = 1.25 ± 0.41 ng/dl, 14% of the patients were current smokers. In Group 3 (n =10) mean age was 53 ± 15 years, mean serum TSH = 2.39 ± 1.12 uUI/ml, and mean serum FT4= 1.28 ± 0.25 ng/dL. There were no patients with history of smoking, current or previous. The mean clinical activity score at the evaluation was 0 ± 1 for all groups, and no differences between the groups regarding age, TSH, and FT4 were found. Regarding patient symptoms about goiter; hypo and hyperthyroidism; eye; tiredness; cognitive complaints; anxiety; depression; emotional susceptibility; impact on emotional and daily life the three groups showed similar results three groups showed similar results.

Conclusion: The Thy-PRO 39 questionnaire showed no difference among the three studied groups. A second course or prolonged use of ATD provides the same quality of life as RAI treatment plus levothyroxine.