Recombinant human TSH increases the efficacy of a fixed activity of radioiodine for treatment of multinodular goitre.
Int J Clin Pract
; 63(4): 583-90, 2009 Apr.
Article
en En
| MEDLINE
| ID: mdl-18803554
ABSTRACT
CONTEXT High doses of (131)I are usually needed in the treatment of multinodular goitre (MNG) for effective thyroid volume (TV) reduction. Recombinant human thyroid-stimulating hormone (rhTSH) is an adjuvant to enhance (131)I uptake, allowing a decrease in radiation activity and enhancing (131)I efficacy. OBJECTIVE:
To evaluate whether rhTSH increases the efficacy of a fixed activity of (131)I for the treatment of MNG.DESIGN:
Two-year, observational, placebo-controlled study.SETTING:
Patients received 0.1 mg rhTSH (A), 0.005 mg rhTSH (B) or placebo (C). A fixed activity of 1.11 GBq of (131)I was administered 24 h after rhTSH or placebo. PATIENTS A total of 28 outpatients (26 females and two males) with MNG. MEASUREMENTS TSH, free T4, T3, thyroglobulin (Tg) and TV.RESULTS:
Basal radioactive iodine uptake and TV values were comparable among all groups. After rhTSH or placebo, peak levels of TSH, free T4, T3 and Tg were higher in A than in B or in C (p < 0.05). Hyperthyroidism was observed in A (n = 2), B (n = 6) and C (n = 4). Thyroid enlargement was reported in A (n = 3) and B (n = 6). After 24 months, 10 patients developed hypothyroidism (four in A, three in B and three in C). TV reduction was similar between A and B (37.2 +/- 25.5% vs. 39.3 +/- 27.9%, p = 0.88), but different from the non-significant reduction in C (15.3 +/- 28.3%, p = 0.08).CONCLUSIONS:
Followed by 1.11 GBq, a very low dose of 0.005 mg rhTSH was equally safe and effective as 0.1 mg rhTSH. Both doses increased the efficacy of radioiodine. Adverse events were mild, transient and readily treatable.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Tirotropina
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Bocio Nodular
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Radioisótopos de Yodo
Tipo de estudio:
Clinical_trials
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Int J Clin Pract
Asunto de la revista:
MEDICINA
Año:
2009
Tipo del documento:
Article
País de afiliación:
Brasil
Pais de publicación:
IN
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INDIA
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ÍNDIA