Predicting remission of Graves' disease following treatment with antithyroid drugs

Natalya V. Drogashevskaya , Ekaterina A. Zhilina , Narine S. Martirosyan , Milena E. Telnova , Ekaterina V. Goncharova , Irina A. Kuzina , Nina A. Petunina

For citation:

Abstract

Graves' disease (GD) is among the most prevalent organ-specific diseases and is one of the most common causes of hyperthyroidism in regions with normal iodine supply. Current therapeutic strategies for the treatment of patients with GD include antithyroid drugs (ATD), thyroid ablation with radioiodine and surgery, which of them is associated with certain risks of complications. The main task of the doctor is to choose the most optimal method to achieve stable remission. In this regard, much attention is paid to the study of predictors of remission, especially after antithyroid drug treatment due to their widespread use as initial therapy. This article is devoted to the consideration of prognostic factors for Graves' disease remission after antithyroid drug treatment.

Key words: Graves' disease, Graves' disease treatment, antithyroid agents, prognostic factors.

References

1. Fadeyev VV. Review of European Thyroid Association Guideline (2018) for the Management of Graves’ Hyperthyroidism. Clin Experiment Thyroidology 2020; 16 (1): 4–20. DOI: 10.14341/ket1 2474

2. Brix TH, Kyvik KO, Christensen K, Hegedus L. Evidence for a major role of heredity in Graves’ disease: a population-based study of two Danish twin cohorts. J Clin Endocrinol Metab 2001; 86: 930–4. DOI: 10.1210/jcem.86.2.7242

3. Inaba H, De Groot LJ, Akamizu T. Thyrotropin receptor epitope and human leukocyte antigen in Graves’ disease. Front Endocrinol 2016; 7: 120. DOI: 10.3389/fendo.2016.00120

4. Lee HJ, Li CW, Hammerstad SS et al. Immunogenetics of autoimmune thyroid diseases: a comprehensive review. J Autoimmun 2015; 64: 82–90. DOI: 10.1016/j.jaut.2015.07.009

5. Manji N, Carr-Smith JD, Boelaert K et al. Influences of age, gender, smoking and family history on autoimmune thyroid disease phenotype. J Clin Endocrinol Metab 2006; 91 (12): 4873–4880. DOI: 10.1210/jc.2006-1402

6. Kahaly GJ, Bartalena L, Hegedüs L et al. 2018 European Thyroid Association Guideline for the Management of Graves' Hyperthyroidism. Eur Thyroid J 2018; 7 (4): 167–86. DOI: 10.1159/000490384. Epub 2018 Jul 25. PMID: 30283735; PMCID: PMC6140607.

7. Bartalena L. Diagnosis and management of Graves disease: a global overview. Nat Rev Endocrinol 2013; 9 (12): 724–34. DOI: 10.1038/nrendo.2013.193

8. Bartalena L, Burch HB, Burman KD, Kahaly GJ. A 2013 European survey of clinical practice patterns in the management of Graves’ disease. Clin Endocrinol 2016; 4 (1): 115–20. DOI: 10.1111/cen. 12688

9. Kahaly GJ, Olivo PD. Graves’ disease. N Engl J Med 2017; 376 (2): 184. DOI: 10.1056/NEJMc1614624

10. Tozzoli R, Bagnasco M, Giavarina D, Bizzaro N. TSH receptor autoantibody immunoassay in patients with Graves’ disease: improvement of diagnostic accuracy over different generations of methods: systematic review and meta-analysis. Autoimmun Rev 2012; 12 (2): 107–13. DOI: 10.1016/j.autrev.2012.07.003

11. Diana T, Wüster C, Olivo PD et al. Performance and specificity of six immunoassays for TSH receptor antibodies: a multicenter study. Eur Thyroid J 2017; 6 (5): 243–9. DOI: 10.1159/000478522

12. Kahaly GJ, Bartalena L, Hegedus L. The American Thyroid Association/American Association of Clinical Endocrinologists guidelines for hyperthyroidism and other causes of thyrotoxicosis: a European perspective. Thyroid 2011; 21 (6): 585–91. DOI: 10.1089/thy.2011. 2106.ed3

13. Erdogan MF, Anil C, Cesur M et al. Color flow Doppler sonography for the etiologic diagnosis of hyperthyroidism. Thyroid 2007; 17 (3): 223–8. DOI: 10.1089/thy.2006.0104

14. Kim TK, Lee EJ. The value of the mean peak systolic velocity of the superior thyroidal artery in the differential diagnosis of thyrotoxicosis. Ultrasonography 2015; 34 (4): 292–6. DOI: 10.14366/usg.14059

15. Ross DS, Burch HB, Cooper DS et al. 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Thyroid 2016; 26 (10): 1343– 421. DOI: 10.1089/thy.2016.0229

16. Brito JP, Schilz S, Singh Ospina N et al. Antithyroid Drugs-The Most Common Treatment for Graves' Disease in the United States: A Nationwide Population-Based Study. Thyroid 2016; 26 (8): 1144–5. DOI: 10.1089/thy.2016.0222. PMID: 27267495.

17. Moon JH, Yi KH. The diagnosis and management of hyperthyroidism in Korea: consensus report of the korean thyroid association. Endocrinol Metab (Seoul) 2013; 28 (4): 275–9. DOI: 10.3803/EnM.2013.28.4.275. PMID: 24396691; PMCID: PMC3871036.

18. Shi H, Sheng R, Hu Y et al. Risk Factors for the Relapse of Graves' Disease Treated With Antithyroid Drugs: A Systematic Review and Meta-analysis. Clin Ther 2020; 42 (4): 662–75.e4. DOI: 10.1016/j.clinthera.2020.01.022. Epub 2020 Mar 2. PMID: 32139177

19. Балаболкин М.И., Ветшев П.С., Петунина Н.А., Трухина Л.В. Хирургическое лечение диффузного токсического зоба и возможности прогнозирования его результатов. Проблемы эндокринологии. 2000; 46 (4): 34–8. [Balabolkin M.I., Vetshev P.S., Petunina N.A., Truhina L.V. Hirurgicheskoe lechenie diffuznogo toksicheskogo zoba i vozmozhnosti prognozirovaniya ego rezul'tatov. Problemy endokrinologii. 2000; 46 (4): 34–8 (in Russian).]

20. Mohlin E, Filipsson H. Nystrom and M. Eliasson: Long-term prognosis after medical treatment of Graves’ disease in a northern Swedish population 2000–2010. Eur J Endocrinol 2014; 170: 419–27. DOI: 10.1530/EJE-13-0811

21. StrujaT,Fehlberg H,KutzAetal.Can wepredict relapse inGraves'disease? Results fromasystematic reviewandmeta-analysis.EurJEndocrinol2017; 176 (1): 87–97. DOI: 10.1530/EJE-16-0725. PMID: 27780830.

22. Vitti P, Rago T, Chiovato L et al. Clinical features of patients with Graves' disease undergoing remission after antithyroid drug treatment. Thyroid 1997; 7 (3): 369–75. DOI: 10.1089/thy.1997.7.369. PMID: 9226205.

23. Liu J, Fu J, Xu Y, Wang G. Antithyroid Drug Therapy for Graves' Disease and Implications for Recurrence. Int J Endocrinol 2017; 2017: 3813540. DOI: 10.1155/2017/3813540. PMID: 28529524; PMCID: PMC5424485

24. Azizi F, Malboosbaf R. Long-Term Antithyroid Drug Treatment: A Systematic Review and Meta-Analysis. Thyroid 2017; 27 (10): 1223– 31. DOI: 10.1089/thy.2016.0652. PMID: 28699478.

25. Nakamura H, Miyauchi A, Miyawaki N, Imagawa J. Analysis of 754 Cases of Antithyroid Drug-Induced Agranulocytosis Over 30 Years in Japan. J Clin Endocrinol Metabol 2013; 98 (12): 4776–83. DOI: 10.1210/jc.2013-2569

26. Azizi F, Malboosbaf R. Safety of long-term antithyroid drug treatment? A systematic review. J Endocrinol Invest 2019; 42 (11): 1273– 83. DOI: 10.1007/s40618-019-01054-1. PMID: 31134536.

27. Azizi F, Amouzegar A, Tohidi M et al. Increased Remission Rates After Long-Term Methimazole Therapy in Patients with Graves' Disease: Results of a Randomized Clinical Trial. Thyroid 2019; 29 (9): 1192–200. DOI: 10.1089/thy.2019.0180. PMID: 31310160.

28. Azizi F, Abdi H, Amouzegar A. Control of Graves' hyperthyroidism with very long-term methimazole treatment: a clinical trial. BMC Endocr Disord 2021; 21 (1): 16. DOI: 10.1186/s12902-020-00670-w. PMID: 33446181; PMCID: PMC7807686

29. Lertwattanarak R, Kunavisarut T, Sriussadaporn S. Benefits of Long-Term Continuation of Low-Dose Methimazole Therapy in the Prevention of Recurrent Hyperthyroidism in Graves' Hyperthyroid Patients: A Randomized Prospective Controlled Study. Int J Endocrinol 2022; 2022: 1705740. DOI: 10.1155/2022/1705740. PMID: 36267362; PMCID: PMC9578883

30. Liu X, Qiang W, Liu X et al. A second course of antithyroid drug therapy for recurrent Graves' disease: an experience in endocrine practice. Eur J Endocrinol 2015; 172 (3): 321–6. DOI: 10.1530/EJE-14- 0704

31. Villagelin D, Romaldini JH, Santos RB et al. Outcomes in Relapsed Graves' Disease Patients Following Radioiodine or Prolonged Low Dose of Methimazole Treatment. Thyroid 2015; 25 (12): 1282–90. DOI: 10.1089/thy.2015.0195

32. Hesarghatta Shyamasunder A, Abraham P. Measuring TSH receptor antibody to influence treatment choices in Graves' disease. Clin Endocrinol (Oxf) 2017; 86 (5): 652–7. DOI: 10.1111/cen.13327

33. Герасимов Г.А., Петунина Н.А., Павлова Т.Л., Трухина Л.В. Роль антител к рецептору тиреотропного гормона в диагностике и прогнозе течения диффузного токсического зоба и эндокринной офтальмопатии. Проблемы эндокринологии. 2001; 47 (4): 38–40. [Gerasimov G.A., Petunina N.A., Pavlova T.L., Truhina L.V. Rol' antitel k receptoru tireotropnogo gormona v diagnostike i prognoze techeniya diffuznogo toksicheskogo zoba i endokrinnoj oftal'mopatii. Problemy endokrinologii. 2001; 47 (4): 38–40 (in Russian).]

34. Park SM, Cho YY, Joung JY et al. Excessive iodine intake does not increase the recurrence rate of graves' disease after withdrawal of the antithyroid drug in an iodine-replete area. Eur Thyroid J 2015; 4 (1): 36–42. DOI: 10.1159/000375261

35. Xu B, Wu D, Ying H, Zhang Y. A pilot study on the beneficial effects of additional selenium supplementation to methimazole for treating patients with Graves’ disease. Turk J Med Sci 2019; 49 (3): 715–22. DOI: 10.3906/sag-1808-67

36. Kahaly GJ, Riedl M, König J et al. Double-Blind, Placebo-Controlled, Randomized Trial of Selenium in Graves Hyperthyroidism. J Clin Endocrinol Metab 2017; 102 (11): 4333–41. DOI: 10.1210/jc.2017-01736. PMID: 29092078.

37. Шабалина Е.А., Фадеев В.В. Эффекты селена в составе консервативной терапии болезни Грейвса. Клиническая и экспериментальная тиреоидология. 2016; 12 (4): 16–30. DOI: 10.14341/ket2016416-30 [Shabalina E.A., Fadeyev V.V. Effects of selenium in patients with Graves’ disease treated with antithyroid drugs. Clinical and experimental thyroidology. 2016; 12 (4): 16–30 (in Russian).]

38. Cho YY, Chung YJ. Vitamin D supplementation does not prevent the recurrence of Graves' disease. Sci Rep 2020; 10 (1): 16. DOI: 10.1038/s41598-019-55107-9

39. Yasuda T, Okamoto Y, Hamada N et al. Serum vitamin D levels are decreased and associated with thyroid volume in female patients with newly onset Graves’ disease. Endocrine 2012; 42 (3): 739–41. DOI: 10.1007/s12020-012-9679-y

For citation:Drogashevskaya N.V., Zhilina E.A., Martirosyan N.S. et al. Predicting remission of Graves' disease following treatment with antithyroid drugs. Clinical review for general practice. 2023; 4 (4): 6–12. DOI: 10.47407/kr2023.4.4.00250

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Clinical review for general practice