Outcomes of Long-Term Follow-up of Patients Receiving Antithyroid Medication for Hyperthyroidism due to Graves' Disease

Abstract

Background: Thyrotropin (also known as thyroid stimulating hormone (TSH)) receptors antibodies (TRAb) activate thyroid follicular cells in the autoimmune condition known as Graves' hyperthyroidism, which causes thyrotoxicosis and swelling of the thyroid gland. Objective: Using a thorough retrospective cohort design, this research assessed the effectiveness of antithyroid drugs (ATDs) and risk variables linked to the recurrence of Graves' hyperthyroidism. Methods: With enough follow-up data, we evaluated 2100 individuals who had just received a Graves' hyperthyroidism diagnosis. Evaluation of the treatment results of the subjects and risk factors for recurrence-free survival, particularly alterations in thyrotropin receptors antibodies. Results: The participants' average age was 44.8 years, and 64% of them were females. After using ATD for a median of 22.9 months (interquartile range (IQR) 16.9-34.4), 1450 participants were given the option to discontinue the medication. Initial remission ratio was 56.6%. 95.24% of participants completed the second round of ATD therapy after the initial recurrence and the remission ratio was 56.6%. 7.14% of participants required surgery, and 10.9% received radioactive iodine treatment, throughout the course of a median follow-up duration of 67 months. About 29.7% of patients were still receiving ATD medication for chronic lower-dose maintained or recurring illness. Male gender, being younger (<45 years old), and fluctuating or smoldering of TRAb levels were all distinct risk indicators for the first recurrence following ATD therapy. Conclusions: ATD therapy is a viable choice for both chronic condition and the first therapy of Graves' hyperthyroidism. The individual risk indicators of recurring must be determined to identify the effective therapeutic duration for ATD therapy.