Prediction for recurrence following antithyroid drug therapy for Graves' hyperthyroidism

被引:2
作者
Weng, Huan [1 ]
Tian, Wen Bo [2 ]
Xiao, Zi Dong [1 ]
Xu, Lin [2 ]
机构
[1] Shantou Cent Hosp, Dept Endocrinol, Shantou, Peoples R China
[2] Sun Yat Sen Univ, Sch Publ Hlth, 74 Zhongshan 2nd Rd, Guangzhou 510080, Guangdong, Peoples R China
来源
ARCHIVES OF ENDOCRINOLOGY METABOLISM | 2023年 / 67卷 / 04期
关键词
Antithyroid agents; recurrence; Graves' disease; risk factors; sleep initiation and maintenance disorders; THYROTROPIN RECEPTOR ANTIBODIES; METHIMAZOLE TREATMENT; DISEASE; GUIDELINE; RELAPSE;
D O I
10.20945/2359-3997000000609
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: A common problem with antithyroid drugs (ATD) treatment in patients with Graves' disease (GD) is the high recurrence rate after drug withdrawal. Identifying risk factors for recurrence is crucial in clinical practice. We hereby prospectively analyze risk factors for the recurrence of GD in patients treated with ATD in southern China. Subjects and methods: Patients who were newly diagnosed with GD and aged > 18 years were treated with ATD for 18 months and followed up for year after ATD withdrawal. Recurrence of GD during follow-up was assessed. All data were analyzed Cox regression with P values < 0.05 considered statistically significant. Results: A total of 127 Graves' hyperthyroidism patients were included. During an average follow-up of 25.7 (standard deviation = 8.7) months, 55 (43%) had a recurrence within 1 year after withdraw of anti-thyroid drugs. After adjustment for potential confounding factors, the significant association remained for the presence of insomnia (hazard ratio (HR) 2.94, 95% confidence interval (CI) 1.47-5.88), greater goiter size (HR 3.34, 95% CI 1.11-10.07), higher thyrotrophin receptor antibody (TRAb) titer (HR 2.66, 95% CI 1.12-6.31) and a higher maintenance dose of methimazole (MMI) (HR 2.14, 95% CI 1.14-4.00). Conclusions: Besides conventional risk factors (i.e., goiter size, TRAb and maintenance MMI dose) for recurrent GD after ATD withdraw, insomnia was associated with a 3-fold risk of recurrence. Further clinical trials investigating the beneficial effect of improving sleep quality on prognosis of GD are warranted.
引用
收藏
页数:7
相关论文
共 28 条
  • [1] A systematic review of drug therapy for Graves' hyperthyroidism
    Abraham, P
    Avenell, A
    Park, CM
    Watson, WA
    Bevan, JS
    [J]. EUROPEAN JOURNAL OF ENDOCRINOLOGY, 2005, 153 (04) : 489 - 498
  • [2] Concentration-dependent regulation of thyrotropin receptor function by thyroid-stimulating antibody
    Ando, T
    Latif, R
    Davies, TF
    [J]. JOURNAL OF CLINICAL INVESTIGATION, 2004, 113 (11) : 1589 - 1595
  • [3] Effect of long-term continuous methimazole treatment of hyperthyroidism: comparison with radioiodine
    Azizi, F
    Ataie, L
    Hedayati, M
    Mehrabi, Y
    Sheikholeslami, F
    [J]. EUROPEAN JOURNAL OF ENDOCRINOLOGY, 2005, 152 (05) : 695 - 701
  • [4] Age May Influence the Impact of TRAbs on Thyroid Function and Relapse-Risk in Patients With Graves Disease
    Bano, Arjola
    Gan, Earn
    Addison, Caroline
    Narayanan, Kilimangalam
    Weaver, Jolanta U.
    Tsatlidis, Vasileios
    Razvi, Salman
    [J]. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2019, 104 (05) : 1378 - 1385
  • [5] Serum thyrotropin receptor antibodies concentrations in patients with Graves' disease before, at the end of methimazole treatment, and after drug withdrawal: Evidence that the activity of thyrotropin receptor antibody and/or thyroid response modify during the observation period
    Carella, C
    Mazziotti, G
    Sorvillo, F
    Piscopo, M
    Cioffi, M
    Pilla, P
    Nersita, R
    Iorio, S
    Amato, G
    Braverman, LE
    Roti, E
    [J]. THYROID, 2006, 16 (03) : 295 - 302
  • [6] Mental Health Status and Factors that Influence the Course of Graves' Disease and Antithyroid Treatments
    Chen, D. Y.
    Schneider, P. F.
    Zhang, X. S.
    He, Z. M.
    Jing, J.
    Chen, T. H.
    [J]. EXPERIMENTAL AND CLINICAL ENDOCRINOLOGY & DIABETES, 2012, 120 (09) : 524 - 528
  • [7] Drug therapy: Antithyroid drugs
    Cooper, DS
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2005, 352 (09) : 905 - 917
  • [8] Second generation assay for thyrotropin receptor antibodies has superior diagnostic sensitivity for Graves' disease
    Costagliola, S
    Morgenthaler, NG
    Hoermann, R
    Badenhoop, K
    Struck, J
    Freitag, D
    Poertl, S
    Weglöhner, W
    Hollidt, JM
    Quadbeck, B
    Dumont, JE
    Schumm-Draeger, PM
    Bergmann, A
    Mann, K
    Vassart, G
    Usadel, KH
    [J]. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1999, 84 (01) : 90 - 97
  • [9] The relationship of psychological factors to the prognosis of hyperthyroidism in antithyroid drug-treated patients with Graves' disease
    Fukao, A
    Takamatsu, J
    Murakami, Y
    Sakane, S
    Miyauchi, A
    Kuma, K
    Hayashi, S
    Hanafusa, T
    [J]. CLINICAL ENDOCRINOLOGY, 2003, 58 (05) : 550 - 555
  • [10] Graves' disease and mental disorders
    Fukao, Atsushi
    Takamatsu, Junta
    Arishima, Takeshi
    Tanaka, Mika
    Kawai, Toshio
    Okamoto, Yasuki
    Miyauchi, Akira
    Imagawa, Akihisa
    [J]. JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY, 2020, 19