OUTCOME FOLLOWING STANDARDIZED 185 MBq DOSE <sup>131</sup>I THERAPY FOR GRAVES' DISEASE

Watson, Angus; Brownlie, B. E. W.; Frampton, Christopher; Turner, John G.; Rogers, T. G. H.

doi:10.1111/j.1365-2265.1988.tb03683.x

Cited by 52 publications

(29 citation statements)

References 16 publications

(1 reference statement)

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“…Since patients with long duration of disease might have to take antithyroid medication for long periods of time, this is also one of the reasons why longer duration affects thyroid gland function. It was reported that thyroid glands of greater weight or larger size need more radiation [7][8][9][10]. Some studies have attempted to determine the optimal radioiodine dose based on weight or size of the thyroid gland [6,9].…”

Section: Discussionmentioning

confidence: 99%

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Onset Age is Associated with Outcome of Radioiodine Therapy in Graves' Disease

et al. 2004

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Abstract. Controversy remains regarding the optimal dose calculation with radioiodine therapy for patients with Graves' disease. Here, we focused our analysis on data concerning the patient's pretreatment background, an empirically set dose of radioiodine and the post-treatment thyroid function, and investigated those factors that affected the outcome. The subjects consisted of 38 patients diagnosed as having Graves' disease. All patients were hospitalized to undertake radioiodine therapy between 1989 and 1998 at our hospital. At the follow-up periods of 6-, 12-, and 36-months after therapy, we divided the patients into two groups: one group those who had hypothyroid function, and the other those who had normal or hyperthyroid function. At 6-and 12-months, 50% of the patients belonged to the hypothyroid function group, whereas at 36-months, 55% of them had hypothyroid function. Logistic regression analysis, with the objective variable being the post-treatment hypothyroidism after 12 months, revealed that the significant factor was the onset age. We suggested that the age at onset should be considered in patients with Graves' disease to determine the optional radioiodine dose for the therapy.

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Section: Discussionmentioning

confidence: 99%

“…It has been reported that males [3,4], younger patients [5,6], patients with more severe hyperthyroidism [5,6], patients with goiters of larger size [5][6][7][8][9][10][11][12], and patients with high TRAb value [11,12] were less likely to be cured after radioiodine therapy. Therefore it is possible to reduce the radioiodine dose for the other patients.…”

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confidence: 99%

Onset Age is Associated with Outcome of Radioiodine Therapy in Graves' Disease

et al. 2004

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“…It can be argued that ablative RAI therapy may be preferable in treating patients with Graves' disease, as the single-dose RAI treatment failure rate is reported to be higher in patients treated with low or calculated RAI doses, whereas the incidence of hypothyroidism is similar in the long-term (2,3,30). It is, however, important to point out that the reported single-dose RAI treatment failure rate ranges from 6% to as high as 33% in patients treated with large ablative RAI doses (4,5,31).…”

Section: Factors Regression Coefficient (B )mentioning

confidence: 99%

Objective estimates of the probability of developing hypothyroidism following radioactive iodine treatment of thyrotoxicosis

Ahmad

Young

2002

European Journal of Endocrinology

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Objective: Several risk factors have been shown individually to influence the outcome following radioactive iodine (RAI) therapy in the treatment of hyperthyroidism. However, no attempt has been made to determine their independent prognostic values that could be used in a regression model to provide objective estimates of the probability of developing hypothyroidism. Study design and methods: We audited records of all hyperthyroid patients treated with first dose RAI between 1980 and 1996. Patients were aetiologically categorized into Graves' disease, solitary toxic nodule and toxic multinodular goiter. Following RAI, outcome was categorized as hypothyroidism, euthyroidism and persistent hyperthyroidism. Multiple logistic regression analysis was used to identify significant risk factors, their prognostic values and probability estimates of developing hypothyroidism in the presence of one or more of these factors. Results: The cumulative incidence of hypothyroidism was 55.8% at 1 year and 86.1% at 10 years. Graves' disease (odds ratio: 4.29), presence of thyroid autoantibodies (odds ratio: 3.51), no antithyroid treatment given prior to RAI (odds ratio: 2.50), non-palpable goiter (odds ratio: 2.48) and high RAI dose (odds ratio: 1.90), were identified as significant independent risk factors. We then developed a predictive table that provides objective estimates of developing hypothyroidism. In the absence of all risk factors we can predict an 11.9% probability of developing hypothyroidism; this increases linearly to a 96.4% probability in the presence of all factors. Conclusions: These objective estimates would help in understanding the relative contributions of the known risk factors, and to predict the probability of developing hypothyroidism following RAI treatment. This would not only help patients make an informed consent for a treatment that would lead to life-long replacement therapy but may also prove useful in calculating the RAI dose that may reduce or delay the onset of developing hypothyroidism.

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“…Reports of low remission rate therapy (6,7) and ease, effectiveness and low expense of radioiodine therapy (8,9), has led to increasing reliance on radioiodine treatment for hyperthyroidism. In fact, more than two thirds of the members of the American Thyroid Association choose radioiodine as the treatment of choice for virtually all patients with Graves' disease (10).…”

Section: Introductionmentioning

confidence: 99%

Effect of long-term continuous methimazole treatment of hyperthyroidism: comparison with radioiodine

Azizi

L²,

Hedayati³

et al. 2005

eur j endocrinol

121

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Objective: To investigate the long-term effects of continuous methimazole (MMI) therapy. Design and methods: Five hundred and four patients over 40 years of age with diffuse toxic goiter were treated with MMI for 18 months. Within one year after discontinuation of MMI, hyperthyroidism recurred in 104 patients. They were randomized into 2 groups for continuous antithyroid and radioiodine treatment. Numbers of occurrences of thyroid dysfunction and total costs of management were assessed during 10 years of follow-up. At the end of the study, 26 patients were still on continuous MMI (group 1), and of 41 radioiodine-treated patients (group 2), 16 were euthyroid and 25 became hypothyroid. Serum thyroid and lipid profiles, bone mineral density, and echocardiography data were obtained. Results: There was no significant difference in age, sex, duration of symptoms and thyroid function between the two groups. No serious complications occurred in any of the patients. The cost of treatment was lower in group 1 than in group 2. At the end of 10 years, goiter rate was greater and antithyroperoxidase antibody concentration was higher in group 1 than in group 2. Serum cholesterol and low density lipoprotein-cholesterol concentrations were increased in group 2 as compared with group 1; relative risks were 1.8 (1.12 -2.95, P , 0.02) and 1.6 (1.09 -2.34, P , 0.02) respectively. Bone mineral density and echocardiographic measurements were not different between the two groups. Conclusion: Long-term continuous treatment of hyperthyroidism with MMI is safe. The complications and the expense of the treatment do not exceed those of radioactive iodine therapy.European Journal of Endocrinology 152 695-701

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OUTCOME FOLLOWING STANDARDIZED 185 MBq DOSE ¹³¹I THERAPY FOR GRAVES' DISEASE

Cited by 52 publications

References 16 publications

Onset Age is Associated with Outcome of Radioiodine Therapy in Graves' Disease

Onset Age is Associated with Outcome of Radioiodine Therapy in Graves' Disease

Objective estimates of the probability of developing hypothyroidism following radioactive iodine treatment of thyrotoxicosis

Effect of long-term continuous methimazole treatment of hyperthyroidism: comparison with radioiodine

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OUTCOME FOLLOWING STANDARDIZED 185 MBq DOSE 131I THERAPY FOR GRAVES' DISEASE

Cited by 52 publications

References 16 publications

Onset Age is Associated with Outcome of Radioiodine Therapy in Graves' Disease

Onset Age is Associated with Outcome of Radioiodine Therapy in Graves' Disease

Objective estimates of the probability of developing hypothyroidism following radioactive iodine treatment of thyrotoxicosis

Effect of long-term continuous methimazole treatment of hyperthyroidism: comparison with radioiodine

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OUTCOME FOLLOWING STANDARDIZED 185 MBq DOSE ¹³¹I THERAPY FOR GRAVES' DISEASE