We have read of too many Graves sufferers being pushed towards either radioactive iodine treatment or surgery. We have also seen quite a few who have stuck with anti-thyroid medicines for many years. Clearly opposing viewpoints. Good to see a paper specifically looking at long term use of anti-thyroid medicines.
Thyroid. 2017 Oct;27(10):1223-1231. doi: 10.1089/thy.2016.0652. Epub 2017 Sep 15.
Long-Term Antithyroid Drug Treatment: A Systematic Review and Meta-Analysis.
Azizi F1, Malboosbaf R1.
1 Endocrine Research Center of Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran, I.R. Iran .
Several studies have reported inconsistent findings on the advantages and disadvantages of long-term treatment with antithyroid drugs (ATD). A systematic review and meta-analysis was undertaken to clarify the numerous aspects of long-term treatment with ATD.
Medline and the Cochrane Library for trials published between 1950 and May 2016 were systematically searched. Studies containing data for long-term (>24 months) ATD treatment were included. Summary estimates of pooled prevalence, odds ratio, and weighted mean difference were calculated with a random effects model.
Of 587 related articles found, six fulfilled the inclusion criteria. Long-term ATD treatment induced a remission rate of 57% [confidence interval (CI) 45-68%], a rate that was higher in adults than in non-adults (61% vs. 53%). The rate of complications was 19.1% [CI 9.6-30.9%], of which only 1.5% were major complications. The annual remission rate for each year of treatment was 16% [CI 10-27%], which was higher in adults than non-adults (19% vs. 14%). However, it should be noted that this is not a true linear correlation, but a positive relationship can be suggested between time and remission rate. Meta-regression revealed that smoking had a significant lowering effect on remission rate.
Long-term ATD treatment is effective and safe, especially in adults, indicating that it should be considered as an alternative treatment for Graves' disease.
Graves' disease; antithyroid drugs; continuous therapy; long-term therapy; meta-analysis; methimazole; propylthiouracil