The use of radioiodine in the management of benign thyroid disease

Weetman, Tony

doi:10.7861/clinmedicine.7-3-214

Cited by 5 publications

(6 citation statements)

References 4 publications

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“…Ross believes that the therapeutic activity of radioiodine should be fixed: 185MBq, 370MBq, or 555MBq, and that its application should result in hypothyroidism [22]. A similar approach is adopted by the British Nuclear Medicine Society, which assures patients that precise computing of therapeutic activity using a formula does not translate into improved therapeutic outcomes, and thus recommends fixed doses of radioiodine (from 400 to 600 MBq) [23]. The European Association of Nuclear Medicine, on the other hand, opts for Marinelli's formula as a way to calculate the therapeutic activity of radioiodine and prefers post-therapeutic euthyroidism to hyperthyroidism.…”

Section: Discussionmentioning

confidence: 99%

Radiojodoterapia w chorobie Gravesa-Basedowa — czynniki wpływające na skuteczność leczenia w oparciu o analizę retrospektywną

Szumowski

Abdelrazek

Sawicka³

et al. 2015

Endokrynologia Polska

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Introduction: Radioiodine ( 131 I) isotope therapy is the method of choice in the treatment of Graves' disease relapse. The efficiency of this method is dependent on many factors; therefore, the present paper aims to identify the parameters that have a crucial impact on the efficacy of radioiodine therapy for Graves' disease. Material and methods:The authors performed a retrospective analysis of the medical documentation of 700 Graves' disease sufferers treated with 131 I. The patients were divided into three groups depending on the thyroid-absorbed dose of

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Section: Discussionmentioning

confidence: 99%

Radiojodoterapia w chorobie Gravesa-Basedowa — czynniki wpływające na skuteczność leczenia w oparciu o analizę retrospektywną

Szumowski

Abdelrazek

Sawicka³

et al. 2015

Endokrynologia Polska

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“…1 The aim of RI therapy is to cure the hyperthyroidism. 2,3 Attempts to calculate a dose of RI that eliminate hyperthyroidism yet prevent hypothyroidism have not produced reliable results, and have been abandoned in the UK and other countries in favour of larger, fixed doses. 2,[4][5][6] As a consequence, the majority of patients develop thyroid hormone dependence within the first year after RI.…”

Section: Introductionmentioning

confidence: 99%

“…Radioiodine (RI) is a safe and effective treatment for Graves' disease (GD) 1 . The aim of RI therapy is to cure the hyperthyroidism 2,3 . Attempts to calculate a dose of RI that eliminate hyperthyroidism yet prevent hypothyroidism have not produced reliable results, and have been abandoned in the UK and other countries in favour of larger, fixed doses 2,4–6 .…”

Section: Introductionmentioning

confidence: 99%

“…A more recent UK‐based survey 6 and large published series 11,16 indicate that such variations in practice persist. Strategies used by clinicians to bridge the transition from hyperthyroidism to euthyroidism on stable L‐T4 therapy following RI include a short course of antithyroid drugs (ATDs) alone, the combination of ATDs with L‐T4 known as “block and replace” (B&R), or watchful monitoring with the introduction of L‐T4 when needed 2,3,6,10 …”

Section: Introductionmentioning

confidence: 99%

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Postradioiodine Graves' management: The PRAGMA study

Perros

Basu

Boelaert

et al. 2022

Clinical Endocrinology

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Objective Thyroid status in the months following radioiodine (RI) treatment for Graves' disease can be unstable. Our objective was to quantify frequency of abnormal thyroid function post‐RI and compare effectiveness of common management strategies. Design Retrospective, multicentre and observational study. Patients Adult patients with Graves' disease treated with RI with 12 months' follow‐up. Measurements Euthyroidism was defined as both serum thyrotropin (thyroid‐stimulating hormone [TSH]) and free thyroxine (FT4) within their reference ranges or, when only one was available, it was within its reference range; hypothyroidism as TSH ≥ 10 mU/L, or subnormal FT4 regardless of TSH; hyperthyroidism as TSH below and FT4 above their reference ranges; dysthyroidism as the sum of hypo‐ and hyperthyroidism; subclinical hypothyroidism as normal FT4 and TSH between the upper limit of normal and <10 mU/L; and subclinical hyperthyroidism as low TSH and normal FT4. Results Of 812 patients studied post‐RI, hypothyroidism occurred in 80.7% and hyperthyroidism in 48.6% of patients. Three principal post‐RI management strategies were employed: (a) antithyroid drugs alone, (b) levothyroxine alone, and (c) combination of the two. Differences among these were small. Adherence to national guidelines regarding monitoring thyroid function in the first 6 months was low (21.4%–28.7%). No negative outcomes (new‐onset/exacerbation of Graves' orbitopathy, weight gain, and cardiovascular events) were associated with dysthyroidism. There were significant differences in demographics, clinical practice, and thyroid status postradioiodine between centres. Conclusions Dysthyroidism in the 12 months post‐RI was common. Differences between post‐RI strategies were small, suggesting these interventions alone are unlikely to address the high frequency of dysthyroidism.

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“…The aim of RI therapy is to cure the hyperthyroidism 2,3 . Attempts to calculate a dose of RI that eliminate hyperthyroidism yet prevent hypothyroidism have not produced reliable results, and have been abandoned in the UK and other countries in favour of larger, fixed doses 2,[4][5][6] .…”

Section: Introductionmentioning

confidence: 99%