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Result: Long-term remission following antithyroid drug withdrawal in patients with Graves' hyperthyroidism: parameters with prognostic value.

Title:
Long-term remission following antithyroid drug withdrawal in patients with Graves' hyperthyroidism: parameters with prognostic value.
Authors:
García-Mayor RV; Endocrine Department, Biomedical Research Institute of Southern Galicia, University Hospital of Vigo, Vigo, Spain. ricardo.garcia.mayor@sergas.es., Álvarez-Vázquez P; Endocrine and Nutrition Service, University Hospital of Orense, Vigo, Spain., Fluiters E; Casco Vello Primary Care Centre, Vigo, Spain., Valverde D; Department of Biochemistry, Genetics and Immunology, University of Vigo, Vigo, Spain., Andrade A; Biochemisty Service, University Hospital of Vigo, Vigo, Spain.
Source:
Endocrine [Endocrine] 2019 Feb; Vol. 63 (2), pp. 316-322. Date of Electronic Publication: 2018 Oct 17.
Publication Type:
Journal Article; Observational Study; Research Support, Non-U.S. Gov't
Language:
English
Journal Info:
Publisher: Springer Country of Publication: United States NLM ID: 9434444 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1559-0100 (Electronic) Linking ISSN: 1355008X NLM ISO Abbreviation: Endocrine Subsets: MEDLINE
Imprint Name(s):
Publication: 2011- : [New York] : Springer
Original Publication: Houndsmills, Basingstoke, Hants, UK : Macmillan Press, c1994-
MeSH Terms:
Withholding Treatment*/statistics & numerical data, Antithyroid Agents/*therapeutic use , Graves Disease/*diagnosis , Graves Disease/*drug therapy, Adult ; Biomarkers/analysis ; Biomarkers/blood ; CTLA-4 Antigen/genetics ; Female ; Genetic Predisposition to Disease ; Genotype ; Graves Disease/genetics ; Graves Disease/pathology ; Graves Ophthalmopathy/diagnosis ; Graves Ophthalmopathy/genetics ; Humans ; Hyperthyroidism/diagnosis ; Hyperthyroidism/drug therapy ; Hyperthyroidism/genetics ; Hyperthyroidism/pathology ; Longitudinal Studies ; Male ; Methimazole/therapeutic use ; Middle Aged ; Polymorphism, Single Nucleotide ; Predictive Value of Tests ; Prognosis ; Remission Induction ; Time Factors ; Treatment Outcome
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Contributed Indexing:
Keywords: +49A/G polymorphism of the CTLA4 gene; Graves’ hyperthyroidism; Graves’ orbitopathy; Methimazole; Predictors of remission
Substance Nomenclature:
0 (Antithyroid Agents)
0 (Biomarkers)
0 (CTLA-4 Antigen)
0 (CTLA4 protein, human)
554Z48XN5E (Methimazole)
Entry Date(s):
Date Created: 20181019 Date Completed: 20200515 Latest Revision: 20200515
Update Code:
20250114
DOI:
10.1007/s12020-018-1785-z
PMID:
30334140
Database:
MEDLINE

Further Information

Objective: To assess the predictive value of some clinical and biochemical parameters, and of the +49 A/G polymorphism of the CTLA-4 gene, for long-term remission following the withdrawal of antithyroid drugs before starting antithyroid drug therapy.
Study Design: Observational, prospective and longitudinal study.
Methods: Seventy-two patients (11 of whom were men) with newly diagnosed Graves' hyperthyroidism who had been attended consecutively at a University Clinic in a population with sufficient iodine intake were included in the study.
Exclusion Criteria: patients under the age of 18, pregnant women and non-Caucasian patients. All subjects were treated following a well-defined protocol. Long-term remission was calculated at 12 and 36 months following withdrawal of the antithyroid drug.
Results: Thirty-six of the 72 study subjects experienced a remission of at least 12 months following withdrawal of methimazole, with no differences according to their age or sex. A comparison made between the remission rates seen in both groups yielded significant differences regarding the presence of Graves' orbitopathy, the duration of the treatment with methimazole and the absence of the CTLA-4 G/G genotype. In the univariate and multivariate analyses performed, only lower frequencies of Graves' orbitopathy and an absence of the CTLA-4 G/G genotype were considered independent predictors of long-term remission.
Conclusions: The absence of Graves' orbitopathy and of the CTLA-4 G/G genotype are independent predictors of long-term remission following a first course of antithyroid drugs.