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Article: The action of methimazole and L-thyroxine in radioiodine therapy: A prospective study on the incidence of hypothyroidism

TitleThe action of methimazole and L-thyroxine in radioiodine therapy: A prospective study on the incidence of hypothyroidism
Authors
Issue Date1995
PublisherMary Ann Liebert, Inc Publishers. The Journal's web site is located at http://www.liebertpub.com/thy
Citation
Thyroid, 1995, v. 5 n. 1, p. 7-12 How to Cite?
AbstractThiourea drugs have been postulated to possess radioprotective property. We studied the effect of adjunctive antithyroid drugs (ATD) and L-thyroxine (L-T4) on the result of radioiodine (RAI) 131I therapy and determined the incidence of hypothyroidism and relapse of hyperthyroidism. One hundred and fifty-nine patients with Graves' disease were randomized prospectively to receive either RAI alone or adjunctive ATD in a form of block-replacement regimen of methimazole (MMI) plus L-T4 for 6 months. The patients were observed for a mean period of 4.6 (range 2-10) years. The incidence of permanent hypothyroidism was studied and the effect of ATD on iodine kinetics was analyzed. The cumulative incidence of hypothyroidism in the ATD group was significantly lower than the RAI group (p = 0.0009), and the difference is accounted by a reduction of early hypothyroidism within 12 months from 20.2 to 3.7% (p = 0.003). The incidence of late hypothyroidism was similar between the two groups. Treatment with ATD did not affect the one dose cure rate with RAI (61.2 vs 55.5%, p = NS), but the time to achieve euthyroidism was significantly earlier with adjunctive ATD (2 vs 8 weeks, p < 0.02). The incidence of relapse within the first year after one dose was also similar between the two groups (38.7 vs 44.5 %, p = NS). Comparing the kinetics of the therapeutic dose with a tracer dose, patients receiving MMI were found to be underdosed by 22% (p = 0.003) and the biological half-life was significantly shortened. We conclude that ATD rendered euthyroidism earlier without com-promising the one dose cure rate of RAI. It also reduced the incidence of RAI-induced hypothyroidism by preventing early hypothyroidism. We advocate adjunctive ATD in view of the more liberal prescription of RAI to young patients.
Persistent Identifierhttp://hdl.handle.net/10722/162081
ISSN
2015 Impact Factor: 3.784
2015 SCImago Journal Rankings: 1.458
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorKung, AWCen_US
dc.contributor.authorYau, CCen_US
dc.contributor.authorCheng, ACKen_US
dc.date.accessioned2012-09-05T05:17:08Z-
dc.date.available2012-09-05T05:17:08Z-
dc.date.issued1995en_US
dc.identifier.citationThyroid, 1995, v. 5 n. 1, p. 7-12en_US
dc.identifier.issn1050-7256en_US
dc.identifier.urihttp://hdl.handle.net/10722/162081-
dc.description.abstractThiourea drugs have been postulated to possess radioprotective property. We studied the effect of adjunctive antithyroid drugs (ATD) and L-thyroxine (L-T4) on the result of radioiodine (RAI) 131I therapy and determined the incidence of hypothyroidism and relapse of hyperthyroidism. One hundred and fifty-nine patients with Graves' disease were randomized prospectively to receive either RAI alone or adjunctive ATD in a form of block-replacement regimen of methimazole (MMI) plus L-T4 for 6 months. The patients were observed for a mean period of 4.6 (range 2-10) years. The incidence of permanent hypothyroidism was studied and the effect of ATD on iodine kinetics was analyzed. The cumulative incidence of hypothyroidism in the ATD group was significantly lower than the RAI group (p = 0.0009), and the difference is accounted by a reduction of early hypothyroidism within 12 months from 20.2 to 3.7% (p = 0.003). The incidence of late hypothyroidism was similar between the two groups. Treatment with ATD did not affect the one dose cure rate with RAI (61.2 vs 55.5%, p = NS), but the time to achieve euthyroidism was significantly earlier with adjunctive ATD (2 vs 8 weeks, p < 0.02). The incidence of relapse within the first year after one dose was also similar between the two groups (38.7 vs 44.5 %, p = NS). Comparing the kinetics of the therapeutic dose with a tracer dose, patients receiving MMI were found to be underdosed by 22% (p = 0.003) and the biological half-life was significantly shortened. We conclude that ATD rendered euthyroidism earlier without com-promising the one dose cure rate of RAI. It also reduced the incidence of RAI-induced hypothyroidism by preventing early hypothyroidism. We advocate adjunctive ATD in view of the more liberal prescription of RAI to young patients.en_US
dc.languageengen_US
dc.publisherMary Ann Liebert, Inc Publishers. The Journal's web site is located at http://www.liebertpub.com/thyen_US
dc.relation.ispartofThyroiden_US
dc.subject.meshAdulten_US
dc.subject.meshDose-Response Relationship, Radiationen_US
dc.subject.meshDrug Therapy, Combinationen_US
dc.subject.meshFemaleen_US
dc.subject.meshGraves Disease - Radiotherapyen_US
dc.subject.meshHumansen_US
dc.subject.meshHypothyroidism - Epidemiology - Etiologyen_US
dc.subject.meshIncidenceen_US
dc.subject.meshIodine Radioisotopes - Adverse Effects - Pharmacokinetics - Therapeutic Useen_US
dc.subject.meshMaleen_US
dc.subject.meshMethimazole - Therapeutic Useen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshRecurrenceen_US
dc.subject.meshThyroxine - Therapeutic Useen_US
dc.titleThe action of methimazole and L-thyroxine in radioiodine therapy: A prospective study on the incidence of hypothyroidismen_US
dc.typeArticleen_US
dc.identifier.emailKung, AWC:awckung@hku.hken_US
dc.identifier.authorityKung, AWC=rp00368en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1089/thy.1995.5.7-
dc.identifier.pmid7787438-
dc.identifier.scopuseid_2-s2.0-0028954905en_US
dc.identifier.hkuros4739-
dc.identifier.volume5en_US
dc.identifier.issue1en_US
dc.identifier.spage7en_US
dc.identifier.epage12en_US
dc.identifier.isiWOS:A1995QK52000002-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridKung, AWC=7102322339en_US
dc.identifier.scopusauthoridYau, CC=7007038422en_US
dc.identifier.scopusauthoridCheng, ACK=36055097300en_US

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