Comparison of placebo with L-thyroxine alone or with carbimazole for treatment of sporadic non-toxic goitre

Berghout, A; Wiersinga, Wilmar M.; Touber, J. L.; Smits, N. J.; Drexhage, Hemmo A.

doi:10.1016/0140-6736(90)91730-x

Cited by 144 publications

(79 citation statements)

References 22 publications

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“…In smaller goitres, L-T 4 suppressive therapy is used by many clinicians (6,7), in spite of little evidence in support of this strategy. The few randomised studies performed have shown no (61) or only a very modest effect (62), and in large goitres L-T 4 is probably even less effective. Faced with a large or substernal goitre, most clinicians turn to surgery (6,7).…”

Section: Therapy In Large Goitresmentioning

confidence: 99%

Controversies in radioiodine therapy: relation to ophthalmopathy, the possible radioprotective effect of antithyroid drugs, and use in large goitres

Bonnema

Bartalena

Toft

et al. 2002

European Journal of Endocrinology

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In routine use for more than 50 years, radioiodine ( 131 I) is generally considered safe and devoid of major side effects. Therefore, it is surprising that relatively many aspects of radioiodine therapy are controversial, as illustrated by recent international questionnaire studies. Our review aims at highlighting three of these areas -namely, the influence of 131 I on the course of Graves' ophthalmopathy, the possible radioprotective effects of antithyroid drugs, and the use of 131 I in large goitres. 131 I therapy carries a small (but definite) risk of causing progression of Graves' ophthalmopathy. Identification of risk factors (thyroid dysfunction, high level of thyroid-stimulating hormone (TSH) receptor antibodies, cigarette smoking) allows the identification of patients at risk and the institution of concomitant glucocorticoid treatment, thereby hindering progression of eye disease.On the basis, largely, of retrospective data, it appears that carbimazole (or methimazole), if stopped 3-5 days before treatment, does not influence the outcome of 131 I therapy. Simultaneous thyrostatic medication most probably reduces the efficacy of 131 I, as does restarting it within 7 days. Propylthiouracil seems to have a more prolonged radioprotective effect than carbimazole.Surgery is the treatment of first choice in patients with a large goitre. However, in the case of patient ineligibility or preference, 131 I therapy may be an option. The treatment has a favourable effect on tracheal compression and inspiratorycapacity, but the reduction in thyroid volume is only 30-40%. Inpatient treatment, necessitated by the large doses, makes the treatment cumbersome.Controversy related to radioiodine therapy is mainly based on the lack of adequate prospective randomised studies comparing efficacy, side effects, cost and patient satisfaction.

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Section: Therapy In Large Goitresmentioning

confidence: 99%

Controversies in radioiodine therapy: relation to ophthalmopathy, the possible radioprotective effect of antithyroid drugs, and use in large goitres

Bonnema

Bartalena

Toft

et al. 2002

European Journal of Endocrinology

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“…In the study of Berghout et al [16], 58% of patients had a significant ( /13%) decrease in thyroid volume. In these responders the mean decrease was 25% after nine months of TSH suppression and was followed by regrowth after discontinuation of therapy.…”

Section: L-thyroxine Suppressive Therapymentioning

confidence: 89%

“…The consequence is subclinical hyperthyroidism affecting adversely the skeleton [22] and the cardiovascular system [23], at least in the elderly. Additionally, lifelong therapy is probably needed to avoid goitre recurrence [5,16], and the natural history of the disease is progression towards hyperthyroidism due to autonomous function of the thyroid nodules [7Á9]. For these reasons, and considering the low efficacy, L-T4 treatment is not feasible in many patients and cannot be recommended.…”

Section: L-thyroxine Suppressive Therapymentioning

confidence: 99%

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Radioiodine therapy in non-toxic multinodular goitre. The possibility of effect-amplification with recombinant human TSH (rhTSH)

Bonnema

Nielsen

2006

Acta Oncologica

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“…This group consists of elderly patients with numerous contraindications and those unwilling to give their consent to surgery. Assuming low goitre growth ratio (on average 10-20% per year), in patients with small goitre and in advanced age, observation and monitoring or, in some cases, antithyroid drug treatment may be sufficient [10]. The need for more invasive therapy starts when cosmetic aspects and symptoms including the compression of the trachea or other structures within the neck appear [11].…”

Section: Discussionmentioning

confidence: 99%

Wole guzowate olbrzymie — ambulatoryjne leczenie radiojodem

Kaniuka-Jakubowska

Lewczuk

Mizan-Gross

et al. 2015

Endokrynologia Polska

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Introduction: 131-I treatment of nodular, especially nontoxic, goitre is still reserved mainly for elderly patients, whose numerous concomitant diseases disqualify them from surgery. Therapy often involves isolation and is available only in selected centres, which may be located far from some patients' places of residence, which is inconvenient for elderly people. The aim of the study was to assess the effectiveness of outpatient fractionated 131-I treatment of patients with large nodular goitres, as well as to evaluate complications and the factors affecting treatment results. Material and methods:The study included 35 patients with a large nodular goitre. Thyroid volume and treatment results were evaluated using US and CT neck examination.

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Comparison of placebo with L-thyroxine alone or with carbimazole for treatment of sporadic non-toxic goitre

Cited by 144 publications

References 22 publications

Controversies in radioiodine therapy: relation to ophthalmopathy, the possible radioprotective effect of antithyroid drugs, and use in large goitres

Controversies in radioiodine therapy: relation to ophthalmopathy, the possible radioprotective effect of antithyroid drugs, and use in large goitres

Radioiodine therapy in non-toxic multinodular goitre. The possibility of effect-amplification with recombinant human TSH (rhTSH)

Wole guzowate olbrzymie — ambulatoryjne leczenie radiojodem

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