Lack of effect of thyroxine in patients with Graves' hyperthyroidism who are treated with an antithyroid drug

Article Abstract:

Administration of thyroxine (T4) in addition to antithyroid drugs in patients with hyperthyroidism due to Graves' disease does not seem to reduce the rate of recurrence of the condition after treatment. The use of thyroxine to suppress secretion of thyrotropin, also called thyroid stimulating hormone, has been thought to inhibit release of antigens by the thyroid gland and thus interfere with the autoimmune response thought to have a role in Graves' disease. Antibodies to the thyrotropin receptor are a sign of an autoimmune response. After a month of treatment with the antithyroid drug carbimazole, 52 patients continued on carbimazole alone and 59 added thyroxine. After 17 months, those taking both drugs stopped the carbimazole treatment, but continued thyroxine treatment for 18 more months. After a median of 12 months from carbimazole withdrawal, there was no difference between the two groups in either recurrence rates or serum concentrations of thyrotropin-receptor antibodies.

Care and treatment, Autoimmune diseases

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Immunosuppression of Graves' hyperthyroidism - still an elusive goal

Article Abstract:

There are conflicting reports of the use of thyroxine (T4) in conjunction with antithyroid therapy in patients with hyperthyroidism due to Graves' disease. The use of thyroxine to suppress secretion of thyrotropin (thyroid stimulating hormone) has been thought to inhibit release of antigens by the thyroid gland and thus interfere with the autoimmune response thought to have a role in Graves' disease. A Japanese study found that thyroxine lowered the rate of recurrence of the condition. But a Scottish study found no effect of thyroxine on recurrence rate. Although the differences may be the result of variation in dose regimen, genetic background, and/or iodine intake, the overall evidence does not support the use of thyroxine after discontinuation of antithyroid therapy. Thyroxine still does, however, have usefulness in combination therapy and holds promise as an immunosuppressive drug for early intervention in Graves' hyperthyroidism.

Editorial

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Drug therapy: Antithyroid drugs

Article Abstract:

Thyroidologists survey from early 1990s in United States and rest of the world indicate that practitioners preferred antithyroid drugs for the treatment of Graves' disease in young people. The reviews taken as of March 2005 considered recent pharmacologic and clinical data related to the use of antithyroid drugs.

United Kingdom, United States, Medicine, Surveys, Dosage and administration, Medical practice

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