Effect of Addition of Thyroxine in the Treatment of Graves' Disease: A Systematic Review

Front Endocrinol (Lausanne). 2021 Jan 25:11:560157. doi: 10.3389/fendo.2020.560157. eCollection 2020.

Abstract

Graves' disease is the most common cause of hyperthyroidism. Antithyroid drugs, radioiodine ablation, and surgery are the main treatments. Research has demonstrated that adding thyroxine to antithyroid therapy can improve the remission rate, and many similar studies have been conducted subsequently. The purpose of this systematic review was to investigate whether adding thyroxine to various treatments for Graves' disease has a clinical benefit in remission/relapse rate, stable thyroid function, occurrence of Graves' ophthalmopathy, etc. A total of 27 studies were included, and the risk of research bias was moderate to high. We discuss the role of thyroxine both in pharmacological and non-pharmacological therapeutic regimens. Overall, the available evidence does not support the indiscriminate addition of thyroxine to various treatments for Graves' disease, especially in combination with oral antithyroid drugs. Further clinical studies are required to explore the indications of thyroxine addition in the treatment of Graves' disease.

Keywords: Graves’ disease; hyperthyroidism; review; thyroxine; treatment.

Publication types

  • Systematic Review

MeSH terms

  • Animals
  • Antithyroid Agents / administration & dosage*
  • Drug Therapy, Combination
  • Graves Disease / diagnosis
  • Graves Disease / drug therapy*
  • Graves Disease / metabolism
  • Graves Ophthalmopathy / diagnosis
  • Graves Ophthalmopathy / drug therapy
  • Graves Ophthalmopathy / metabolism
  • Humans
  • Thyroxine / administration & dosage*
  • Treatment Outcome

Substances

  • Antithyroid Agents
  • Thyroxine