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Objective: Remission Rate of Graves’ disease (GD) by Anti-thyroid Drugs (ATD) remains around 50% and renovated ATD is not expected soon. As GD is an autoimmune disease associated with Anti-TSH receptor Auto-antibodies (TRAb) and blood TRAb levels presumably reflect immune dysregulation, better practice of ATD therapy could be worked out using TRAb. Methods: 101 patients were treated with ATD in a titration regimen. Their serum TRAb levels were serially measured by a 2nd generation assay (DYNO test TRAKTM human kit), henceforth designated as hTRAb levels. ATD was continued until the hTRAb levels become undetectable (<1.0 IU/L) consecutively twice (Target A) or reducing in gray-zone (1.0-1.5 IU/L) (Target B). Remission rates, defined by no relapse within-one-year postATD, were assessed in patients having attained Target A or Target B. Time Courses (TCs) of hTRAb levels were drawn. Relations of TC patterns and outcomes were sought. Results: The relapse-free remission rate of patients having attained Target A (N=41) among those having attained Target A with or without relapse (N=52) was 78.8 %. The relapse-free remission rate of patients having attained either Target A or Target B (N=52) in the total patients was 51.5 %. Remission was associated with four TC patterns; throughout undetectable levels, gradual reducing and converging to undetectable levels twice, reducing and converging in gray-zone levels, and one or two flair-ups in gradually reducing levels. Conclusion: Until better biomarkers reflecting altered immune status become available, outcomes of GD can be predicted by serially measured TRAb levels during ATD treatment.

utcome of Graves’ Disease Treated with Anti-Thyroid Drugs and Time Courses of Anti-Tsh Receptor Antibodies