Long-term thionamide antithyroid treatment of Graves' disease

Best Pract Res Clin Endocrinol Metab. 2023 Mar;37(2):101631. doi: 10.1016/j.beem.2022.101631. Epub 2022 Feb 24.

Abstract

Thionamide antithyroid drugs (ATD) are the treatment of choice for Graves' hyperthyroidism. The major drawback of ATD treatment for 1-2 years is the relapse of hyperthyroidism in about 50% of patients. Recently, it has been shown that ATD treatment for more than five years is accompanied by long-term remission in majority of patients without additional major side effects in both adults and children. Compared to radioactive iodine therapy, long-term ATD results in more favorable outcomes. This review summarizes the evidence on long-term ATD therapy regarding the remission rate of hyperthyroidism, efficacy and safety, indications and mode of therapy in patients with hyperthyroidism.

Keywords: Graves' hyperthyroidism; antithyroid drugs; long-term treatment; methimazole; thionamide.

Publication types

  • Review

MeSH terms

  • Adult
  • Antithyroid Agents / adverse effects
  • Child
  • Graves Disease* / drug therapy
  • Graves Disease* / radiotherapy
  • Humans
  • Hyperthyroidism* / drug therapy
  • Iodine Radioisotopes / therapeutic use
  • Methimazole / adverse effects
  • Neoplasm Recurrence, Local
  • Thyroid Neoplasms* / drug therapy
  • Treatment Outcome

Substances

  • Methimazole
  • Iodine Radioisotopes
  • Antithyroid Agents