The Relationship between Third-generation TSH Receptor Antibody Positivity and Cumulative Methimazole Dose Used until Remission in Graves' Disease

J Coll Physicians Surg Pak. 2021 May;31(5):517-522. doi: 10.29271/jcpsp.2021.05.517.

Abstract

Objective: To determine the relationship between the positivity of third-generation TSH receptor antibody (TRAb) at the time of diagnosis and the cumulative methimazole dose used until remission in patients with Graves' disease.

Study design: Cross-sectional, descriptive study.

Place and duration of study: Department of Endocrinology and Metabolic Diseases, University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, Turkey from 2016 to 2018.

Methodology: Newly diagnosed Graves' patients were included in the study. The patients were divided into two groups according to whether they entered remission (n: 21) or not (n: 20), in the 18th month of methimazole treatment. In addition, the patients were further divided into two categories, according to TRAb status at the time of diagnosis as negative (n: 17) or positive (n: 24). The TRAb positivity and the cumulative methimazole dose they used until the month of remission were compared in these groups.

Results: The mean time to reach remission in 41 patients was 20.5 ± 3.1 months. TSH receptor antibody positivity rate was 58.5%. When the TRAb positivity of the groups was compared according to the state of having remission in the 18th month of the treatment, the positivity rate in the non-remission group was statistically significantly higher (p = 0.023).The time to go into remission was longer and the cumulative methimazole dose requirement was higher in the TRAb positive group (p <0.001).

Conclusion: Graves' disease patients with positive third-generation TRAb were found to have a lower rate of remission in the 18-month period compared to negative patients. Key Words: Graves' disease, TSH receptor antibody, Cumulative, Methimazole.

MeSH terms

  • Antithyroid Agents / therapeutic use
  • Autoantibodies
  • Cross-Sectional Studies
  • Graves Disease* / drug therapy
  • Humans
  • Immunoglobulins, Thyroid-Stimulating
  • Methimazole* / therapeutic use
  • Receptors, Thyrotropin
  • Turkey

Substances

  • Antithyroid Agents
  • Autoantibodies
  • Immunoglobulins, Thyroid-Stimulating
  • Receptors, Thyrotropin
  • thyrotropin-binding inhibitory immunoglobulin
  • Methimazole