Improvement of Goiter Volume Reduction after 0.3 mg Recombinant Human Thyrotropin-Stimulated Radioiodine Therapy in Patients with a Very Large Goiter: A Double-Blinded, Randomized Trial
| Autor: | Lars Bastholt, Peter B. Andersen, Viveque Egsgaard Nielsen, Steen Joop Bonnema, Henrik Boel-Jørgensen, Laszlo Hegedüs, Peter Grupe |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male endocrine system medicine.medical_specialty Goiter Randomization endocrine system diseases Endocrinology Diabetes and Metabolism Clinical Biochemistry Thyrotropin chemistry.chemical_element Thyroid Function Tests Placebo Iodine Biochemistry law.invention Iodine Radioisotopes Placebos Endocrinology Double-Blind Method Thyroid-stimulating hormone Randomized controlled trial law Internal medicine medicine Humans Aged Aged 80 and over Dose-Response Relationship Drug medicine.diagnostic_test business.industry Biochemistry (medical) Magnetic resonance imaging Organ Size Middle Aged medicine.disease Recombinant Proteins eye diseases chemistry Chemotherapy Adjuvant Patient Satisfaction Recombinant DNA Female business |
| Zdroj: | Bonnema, S, Nielsen, V E, Boel-Jørgensen, H, Grupe, P, Andersen, P B, Bastholt, L & Hegedüs, L 2007, ' Improvement of goiter volume reduction after 0.3 mg recombinant human thyrotropin-stimulated radioiodine therapy in patients with a very large goiter: a double-blinded, randomized trial ', Journal of Clinical Endocrinology and Metabolism, vol. 92, no. 9, pp. 3424-3428 . https://doi.org/10.1210/jc.2007-0501 |
| ISSN: | 1945-7197 0021-972X |
| DOI: | 10.1210/jc.2007-0501 |
| Popis: | Udgivelsesdato: 2007-Sep INTRODUCTION: The effect of (131)I therapy amplification by recombinant human (rh) TSH prestimulation in very large goiters has not been evaluated in a double-blinded, placebo-controlled study. METHODS: Twenty-nine patients (22 females; age range 37-87 yr) with a large multinodular goiter (median 160 ml, range 99-440 ml) were randomized to receive placebo (n = 15) or 0.3 mg rhTSH (n = 14) 24 h before (131)I administration. Goiter volume was monitored by magnetic resonance imaging. RESULTS: On average, the goiter volume was unchanged 1 wk after therapy in both groups, but the largest deviations from baseline were observed in the rhTSH group. After 12 months the median goiter volume was reduced from 170 to 121 ml in the placebo group and from 151 to 72 ml in the rhTSH group, respectively (within group: P = 0.001; between group: P = 0.019). This corresponds to reductions of 34.1 +/- 3.2 and 53.3 +/- 3.3%, respectively (between group: P < 0.001). In the placebo group, the goiter reduction correlated positively with the retained thyroid (131)I dose, whereas such a relationship was absent in the rhTSH group. Adverse effects, mainly related to thyroid pain and cervical compression, were more frequent in the rhTSH group. At 12 months, goiter-related complaints were significantly reduced in both groups without any between-group difference. One and three patients in the placebo and the rhTSH group, respectively, developed hypothyroidism. CONCLUSION: rhTSH-stimulated (131)I therapy improves the reduction of very large goiters by more than 50%, compared with (131)I therapy alone, but at the expense of more adverse effects after therapy. Our data suggest that rhTSH stimulation may work through mechanisms that go beyond the increase in thyroid (131)I uptake |
| Databáze: | OpenAIRE |
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