Thyroid-Associated Ophthalmopathy after Treatment for Graves’ Hyperthyroidism with Antithyroid Drugs or Iodine-131
| Autor: | Frank, Träisk, Leif, Tallstedt, Mirna, Abraham-Nordling, Tommy, Andersson, Gertrud, Berg, Jan, Calissendorff, Bengt, Hallengren, Pavo, Hedner, Mikael, Lantz, Ernst, Nyström, Vesna, Ponjavic, Adam, Taube, Ove, Törring, Göran, Wallin, Peter, Asman, Göran, Lundell, H, Blomgren |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty endocrine system diseases Endocrinology Diabetes and Metabolism Graves' disease medicine.medical_treatment Clinical Biochemistry Thyrotropin Context (language use) Kaplan-Meier Estimate Hyperthyroidism Biochemistry law.invention Iodine Radioisotopes Graves' ophthalmopathy Endocrinology Antithyroid Agents Randomized controlled trial Risk Factors law Internal medicine Immunopathology medicine Humans Aged Proportional Hazards Models Autoimmune disease Proportional hazards model business.industry Antithyroid agent Biochemistry (medical) Middle Aged medicine.disease Graves Ophthalmopathy Disease Progression Female business |
| Zdroj: | The Journal of Clinical Endocrinology & Metabolism. 94:3700-3707 |
| ISSN: | 1945-7197 0021-972X |
| DOI: | 10.1210/jc.2009-0747 |
| Popis: | Previous randomized trials have suggested an association between radioiodine treatment for Graves' hyperthyroidism and thyroid-associated ophthalmopathy (TAO).The aim of the study was to compare the occurrence of worsening or development of TAO in patients who were treated with radioiodine or antithyroid drugs.We conducted a randomized trial (TT 96) with a follow-up of 4 yr. PATIENTS, SETTING, AND INTERVENTION: Patients with a recent diagnosis of Graves' hyperthyroidism were randomized to treatment with iodine-131 (163 patients) or 18 months of medical treatment (150 patients). Early substitution with T(4) was given in both groups.Worsening or development of TAO was significantly more common in the iodine-131 treatment group (63 patients; 38.7%) compared with the medical treatment group (32 patients; 21.3%) (P0.001).The risk for de novo development of TAO was greater in patients treated with iodine-131 (53 patients) than with medical treatment (23 patients). However, worsening of TAO in the 41 patients who had ophthalmopathy already before the start of treatment was not more common in the radioiodine group (10 patients) than in the medical group (nine patients). Smoking was shown to influence the risk of worsening or development of TAO, and smokers treated with radioiodine had the overall highest risk for TAO. However, in the group of smokers, worsening or development of TAO was not significantly associated with the choice of treatment for hyperthyroidism.Radioiodine treatment is a significant risk factor for development of TAO in Graves' hyperthyroidism. Smokers run the highest risk for worsening or development of TAO irrespective of treatment modality. |
| Databáze: | OpenAIRE |
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