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Comparison of efficacy and adverse effects between methimazole 15 mg+inorganic iodine 38 mg/day and methimazole 30 mg/day as initial therapy for Graves' disease patients with moderate to severe hyperthyroidism.
- Source :
-
Thyroid : official journal of the American Thyroid Association [Thyroid] 2015 Jan; Vol. 25 (1), pp. 43-50. - Publication Year :
- 2015
-
Abstract
- Background: Methimazole (MMI) is usually used at an initial dose of 30 mg/day for severe Graves' disease (GD) hyperthyroidism, but adverse effects are more frequent at this dose than at MMI 15 mg/day.<br />Objectives: We designed a regimen to address the lack of a primary therapeutic effect of the MMI 15 mg/day by combining it with inorganic iodine at 38.2 mg/day. Our aim was to compare the two regimens (MMI 15 mg+inorganic iodine at 38.2 mg/day (M15+I) vs. MMI 30 mg/day (M30)) in terms of therapeutic effect, adverse effects, and remission rate.<br />Design and Patients: In a prospective study, 310 patients with untreated GD (serum free thyroxine (fT4) ≥5 ng/dL) were assigned to one of the two regimens. Potassium iodide was discontinued in the M15+I group as soon as the serum fT4 level was within the reference range (0.8-1.6 ng/dL).<br />Results: Percentages of patients achieving an fT4 level within reference range in ≤30, ≤60, or 90 days on the study treatment regimens were 45.3%, 73.9%, and 82.0% respectively for the M15+I group, and 24.8%, 63.1%, and 75.2% respectively for the M30 group. Hence, the proportions of patients achieving this goal in ≤30 or ≤60 days were significantly larger in the M15+I group. Adverse effects that required discontinuation of MMI were more frequent in the M30-treated than in the M15+I-treated group (14.8% vs. 7.5%; p=0.0387). The remission rates in the M15+I and M30 groups were 19.9% and 14.8%-higher in the former, but the difference did not reach statistical significance.<br />Conclusion: The results of this study raise the possibility that M15+I is superior to M30 as a primary treatment for moderate to severe hyperthyroidism caused by GD.
- Subjects :
- Adolescent
Adult
Aged
Antithyroid Agents administration & dosage
Antithyroid Agents adverse effects
Child
Drug Administration Schedule
Drug Therapy, Combination
Female
Graves Disease blood
Humans
Male
Methimazole administration & dosage
Methimazole adverse effects
Middle Aged
Potassium Iodide adverse effects
Thyroid Function Tests
Thyroxine blood
Treatment Outcome
Triiodothyronine blood
Young Adult
Antithyroid Agents therapeutic use
Graves Disease drug therapy
Methimazole therapeutic use
Potassium Iodide therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1557-9077
- Volume :
- 25
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Thyroid : official journal of the American Thyroid Association
- Publication Type :
- Academic Journal
- Accession number :
- 25178068
- Full Text :
- https://doi.org/10.1089/thy.2014.0084