Long-Term Follow-up of Graves Orbitopathy After Treatment With Short- or Long-Term Methimazole or Radioactive Iodine.
Endocr Pract
; 29(4): 240-246, 2023 Apr.
Article
em En
| MEDLINE
| ID: mdl-36649782
ABSTRACT
OBJECTIVE:
The aim of this study was to compare long-term outcomes in terms of new onset or worsening of Graves orbitopathy (GO) in patients with Graves disease treated with different therapeutic modalities for hyperthyroidism.METHODS:
A total of 1163 patients with Graves disease were enrolled in this study; 263 patients were treated with radioiodine and 808 patients received methimazole (MMI) therapy for a median of 18 months, of whom 178 patients continued MMI for a total of 96 months (long-term methimazole [LT-MMI]). The thyroid hormonal status and GO were evaluated regularly for a median of 159 months since enrollment.RESULTS:
The rates of relapse, euthyroidism, and hypothyroidism at the end of follow-up were as follows radioiodine treatment group 16%, 22%, and 62%, respectively; short-term MMI group 59%, 36%, and 5%, respectively; and LT-MMI group 18%, 80%, and 2%, respectively. During the first 18 months of therapy, worsening of GO (11.5% vs 5.7%) and de novo development of GO (12.5% vs 9.8%) were significantly more frequent after radioiodine treatment (P <.004). Overall worsening and de novo development of GO from >18 to 234 months occurred in 26 (9.9%) patients in the radioiodine group and 8 (4.5%) patients in the LT-MMI group (P <.037). No case of worsening or new onset of GO was observed in patients treated with LT-MMI from >60 to 234 months of follow-up.CONCLUSION:
Progression and development of GO were associated more with radioiodine treatment than with MMI treatment; GO may appear de novo or worsen years after radioiodine treatment but not after LT-MMI therapy.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Glândula Tireoide
/
Doença de Graves
/
Oftalmopatia de Graves
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article