Although Graves' disease (GD) is common in endocrine practices worldwide, global differences in diagnosis and management remain. We sought to assess the current practices for GD in countries across Asia and the Paci c (APAC), and to compare these with previously published surveys from North-America and Europe.
MethodsA web-based survey on GD management was conducted on a pool of practicing physicians. Responses from 542 eligible physicians were received and subsequently analysed and compared to outcomes from other, similar surveys.
ResultsDuring initial work-up, majority of respondents would request thyroid-stimulating hormone (TSH; 73%) and free thyroxine assays (75%), as well as TSH-receptor autoantibodies (68%). Thyroid ultrasound would be requested by about half of respondents (53%), while the use of nuclear medicine scans was very limited. The preferred rst-line treatment was antithyroid drug (ATD) therapy (79%) with methimazole (MMI) or carbimazole (CBZ), followed by radioiodine (RAI; 19%) and surgery (2%). In case of surgery, onethird of respondents would opt for a subtotal rather than a total thyroidectomy. In case of mild Graves orbitopathy (GO), ATDs (67%) remained the preferred treatment, but a larger proportion would prefer surgery (20%). For a patient with a pregnancy (wish), the overall preferred treatment pattern remained unchanged, although propylthiouracil (PTU) became the preferred ATD-agent during the rst trimester.While on most issues choices of the physicians from APAC fell between European and American practices, marked differences were noted in the relatively infrequent usage of nuclear medicine scans and the overall higher concomitant use of a ATDs and β-blockers and adjunctive ATD-treatment during RAI.
ConclusionAlthough regional differences regarding the diagnosis and management of GD are apparent in this rst pan-Asia-Paci c survey, the overall approach to the management of this disease in APAC to generally fall between the trends appreciated in the American and European cohorts.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.