Antithyroid Drugs in Iodine 131 Therapy of Hyperthyroidism

Einhorn, J.; Säterborg, N.-E.

doi:10.3109/00016926209169557

Cited by 20 publications

(4 citation statements)

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“…Since the earlier uses of RAI, pretreatment with ATD has been associated with a higher treatment failure (6)(7)(8). However, the influence of ATD on the outcome of RAI therapy is still controversial (9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

Propylthiouracil Reduces the Effectiveness of Radioiodine Treatment in Hyperthyroid Patients with Graves' Disease

Santos

Romaldini

Ward

2004

Thyroid

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In order to assess the effect of propylthiouracil (PTU) or methimazole (MMI) pretreatment on patient outcome after radioiodine therapy, we examined 100 patients with Graves' disease 3, 6, 9, and 12 months after administration of a 10-mCi standard single dose of 131I. They were assigned to one of three groups: no drug (ND) treatment (30 cases); MMI (45 cases); and PTU (25 cases). Antithyroid drugs (ATD) were withdrawn 15 days before radioiodine administration. The groups were similar concerning age, gender, ATD pretreatment duration, goiter size, and initial serum triiodothyronine (T3), thyroxine (T4), free thyroxine (FT4), antithyroid autoantibody levels, 24-hour radioiodine uptake and 131I dose administered per gram of thyroid tissue. ND and MMI groups presented a similar rate of cure of 73.3% and 77.8% respectively (p = NS). In contrast, the PTU group showed a rate of cure of only 32% (p < 0.05). Logistic regression analysis indicated that PTU administration (p = 0.003) and thyroid size (p = 0.02) were the variables related to radioiodine therapy failure. Our data demonstrate that the chance of 131I treatment failure is higher in individuals using PTU than in patients using MMI or not using any ATD before radioiodine (odds ratio [OR] 5.84; 95% confidence interval [CI] 1.82-18.76) suggesting that PTU should be avoided in the treatment of patients with Graves' disease.

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Section: Introductionmentioning

confidence: 99%

Propylthiouracil Reduces the Effectiveness of Radioiodine Treatment in Hyperthyroid Patients with Graves' Disease

Santos

Romaldini

Ward

2004

Thyroid

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“…Radio resistance conferred by thioureas is believed to be due to their sulfhydryl groups. [ 34 ] As CMZ does not have a sulfhydryl group, it was proposed that it confers no radioresistance. [ 29 34 ] In many of the studies examining the effect of ATD on 131 I, PTU or CMZ were used as pretreatment for several weeks before 131 I and very few studies examined the effects of long-term ATD used as a primary therapy for several months of GD.…”

Section: Discussionmentioning

confidence: 99%

Long-term carbimazole pretreatment reduces the efficacy of radioiodine therapy

Shivaprasad

Kumar

2015

Indian J Endocr Metab

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Introduction:Data from several studies suggest that pretreatment with antithyroid drugs (ATD) before 131I increases the risk of treatment failure. This effect has been demonstrated more consistently with propylthiouracil than with carbimazole (CMZ) or methimazole (MMI). Men with Graves’ disease (GD) have a lower rate of remission with 131I compared to women and the impact of long-term ATD pretreatment on the success of 131I is unknown. The objective of our study was to compare the efficacy of fixed doses of radioiodine between patients with and without long-term CMZ pretreatment.Materials and Methods:We performed a retrospective study on 335 male patients with GD treated with 131I from 1998 to 2008. 148 patients had been pretreated with CMZ, and the remaining 187 patients received 131I without pretreatment. We compared the success rate of a single dose of 131I, between patients with and without long-term CMZ pretreatment.Results:The success rate of a single dose of 131I was significantly higher in patients without pretreatment than in patients who were pretreated with CMZ (91.4% vs. 82.3%, P = 0.01). The rate of hypothyroidism in the first 6 months after 131I therapy was significantly higher in patients without pretreatment (55.1% vs. 44.6%, P = 0.05). There was also a trend for higher cumulative rate of hypothyroidism at last follow-up in nonpretreated patients (78.1% vs. 69.7%).Conclusion:Male patients with Graves’ hyperthyroidism pretreated with CMZ have lower efficacy with 131I therapy compared to nonpretreated patients. CMZ pretreatment given for a prolonged period reduces the efficacy of 131I therapy.

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“…O menor número de pacientes em uso de propiltiouracil também é um fator limitante para as conclusões aqui sugeridas; entretanto, outros dados da literatura fortalecem os nossos achados. Tem sido sugerido que as tionamidas levam a uma radiorresistência devido à presença de um grupamento sufadril, no entanto carbimazol não apresenta tal grupamento (10 (14).…”

Section: Discussionunclassified

Fatores associados com recidiva precoce do hipertireoidismo após tratamento com radioiodoterapia

Lima¹,

Nóbrega²,

Nóbrega³

et al. 2003

Arq Bras Endocrinol Metab

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RESUMOObjetivos: Avaliar os fatores associados com persistência ou recorrência do hipertireoidismo após tratamento com 131 I. Metodologia: Análise retrospectiva de prontuários de todos os pacientes com hipertireoidismo tratados com dose fixa de 400MBq de 131 I em um centro especializado (1992 a 1997 From the 104 patients treated during that period, six had a multinodular goitre and one, a toxic adenoma; 96 were taking thionamide preparations, which were discontinued 7 days prior to radioiodine administration. Results: Early progression to hypothyroidism was observed at a median of 88 days (22-214) in 60 patients (57.7%). Persistence or early recurrence of hyperthyroidism was observed in 13 (12.5%) and was positively correlated with age (p<0.007), although unrelated to underlying diagnosis. There was a higher prevalence of persistent disease in those treated with propylthiouracil rather than carbimazol prior to radioiodine (35% vs. 8%; p<0.006). Conclusions: This study suggests that the blocking effect of thionamides on radioiodine uptake may be more prolonged in older people. It also suggests that the effect of propylthiouracil may last longer than that of carbimazol. (Arq Bras Endocrinol Metab 2003;47/6:701-704) Keywords: Iodine; Radioiodine; Hyperthyroidism; Graves; Recurrence A DMINISTRAÇÃO ORAL de 131 I é largamente aceita como um tratamento simples, efetivo e aparentemente seguro para hipertireoidismo. Doses menores, tituladas e repetidas têm sido advogadas para reduzir a incidência de hipotireoidismo (1), entretanto têm-se discutido seu baixo custo-benefí-

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Antithyroid Drugs in Iodine 131 Therapy of Hyperthyroidism

Cited by 20 publications

References 4 publications

Propylthiouracil Reduces the Effectiveness of Radioiodine Treatment in Hyperthyroid Patients with Graves' Disease

Propylthiouracil Reduces the Effectiveness of Radioiodine Treatment in Hyperthyroid Patients with Graves' Disease

Long-term carbimazole pretreatment reduces the efficacy of radioiodine therapy

Fatores associados com recidiva precoce do hipertireoidismo após tratamento com radioiodoterapia

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