Journal Logo

You can read the full text of this article if you:

Access through Ovid
00019616-200010060-00007ReviewThe EndocrinologistThe Endocrinologist© 2000 Lippincott Williams & Wilkins, Inc.10November 2000 p 403-411Effect of Pretreatment with Antithyroidal Drugs on the Failure Rate of Radioiodine Therapy in Graves' DiseaseCME Review Articles: PDF OnlyTuttle, Michael R. M.D.*Joan and Sanford I. Weill Medical College of Comell University, New York, New York; and Endocrinology Service, Memorial Sloan Kettering Cancer Center, New York, New York.Address correspondence to: R. Michael Tuttle, M.D., Endocrinology Service, Memorial Sloan Kettering Cancer Center, Box 419 (H-715), 1275 York Avenue, New York, New York 10021. Phone: 212-639-6042; Fax: 212-794-5821; E-mail:[email protected]*The author discloses: Grant/research support recipient from Knoll Pharmaceutical; member of the speaker's bureau of Knoll Pharmaceutical and Genzyme.AbstractRadioactive iodine is now widely used as definitive therapy for Graves' Disease. As part of routine clinical practice, many physicians recommend pretreatment with antithyroidal medications for several weeks prior to radioactive iodine therapy in an effort to minimize any risk of precipitating thyroid storm. Recently, several studies have failed to demonstrate any clinically significant changes in serum thyroid hormone levels immediately following RAI administration. Furthermore, pretreatment with antithyroidal drugs, even when discontinued for several days before RAI administration, has been reported to result in a significant decrease in the effectiveness of RAI. A careful analysis of the data reveals that propylthiouracil, but not methimizole, has significant radioprotective properties when used as pretreatment before RAI dosing. Since radioactive iodine therapy can be safely administered following adequate beta-adrenergic blockade in most patients, these data question the rationale for routine use of antithyroidal drug therapy before RAI therapy. This review carefully analyzes the available data concerning the effect of pretreatment with antithyroidal medications on the failure rate of subsequent RAI therapy in Graves' Disease.The Endocrinologist 2000; 10: 403-411Section DescriptionCHIEF EDITOR'S NOTE: This article is the 35th of 36 that will be published in 2000 for which a total of up to 36 Category 1 CME credits can be earned. Instructions for how credits can be earned appear following the Table of Contents.Effect of Pretreatment with Antithyroidal Drugs on the Failure Rate of Radioiodine Therapy in Graves' DiseaseTuttle Michael R. M.D.CME Review Articles: PDF OnlyCME Review Articles: PDF Only610p 403-411