Treatment of Graves' disease (GD) with antithyroid drugs (ATD) leads to remission of the disease in approximately half of patients treated for at least 6 months. The overall relapse rate is high. Prognostic features that predict a remission after medical treatment are still a matter of controversy in the literature. The aim of this study is to evaluate the uuse of clinical and laboratory data for predicting a remission of GD after 12 months of treatment with ATD.
The study included 46 previously untreated patients who were treated for 12 months and followed for at least 12 months after drug withdrawal.
Remission was observed in 25 patients and there was only 1 relapse. Greater duration of symptoms before the beginning of medical treatment, large goiter and high baseline levels of serum free T4, total T3, TRAb, and TPOAb were associated with a decreased remission rate. Individuals who presented a thyroid-stimulating hormone measurement <0.4 μIU/mL at 4 to 5 weeks after drug withdrawal presented a no remission rate 7.8 times higher than individuals with normal thyroid-stimulating hormone measurement.
Our results confirm that the rate of lasting remissions of GD treated with ATD is relatively low. Initial goiter size, duration of symptoms and baseline T3, free T4, TRAb, and TPOAb can select a subgroup of patients with GD who will most likely benefit from antithyroid drug treatment as a first choice.