Open AccessManagement of Graves’ Hyperthyroidism: More Than a Century of Progression
Author(s) -
Hengameh Abdi,
Atieh Amouzegar
Publication year - 2020
Publication title -
international journal of endocrinology and metabolism/international journal of endocrinology and metabolism.
Language(s) - English
Resource type - Journals
eISSN - 1726-9148
pISSN - 1726-913X
DOI - 10.5812/ijem.103943
Subject(s) - medicine , context (archaeology) , graves' disease , intensive care medicine , antithyroid drugs , treatment modality , thyroid , modality (human–computer interaction) , modalities , term (time) , disease , pediatrics , surgery , paleontology , social science , physics , human–computer interaction , quantum mechanics , sociology , computer science , biology
Context: There are three therapeutic modalities for the management of Graves’ disease (GD), including thyroid surgery, radioactive iodine (RAI), and antithyroid drugs (ATDs). We aimed to briefly review the history of these treatment strategies and their advantages and disadvantages. Evidence Acquisition: We searched PubMed for English language articles using pertinent search terms. Results: Each treatment modality for GD is accompanied by several advantages and disadvantages. Nowadays, ATDs are the most commonly prescribed therapy for GD worldwide. The lack of well-designed, large RCTs comparing three different treatments for hyperthyroidism concerning various short-term and long-term outcomes has led to remarkable uncertainty in the preference of each of these treatments, as is evident in relevant guidelines from different societies. Recently, the efficacy and safety of long-term use of ATDs have been documented. Conclusions: Pros and cons of each therapeutic modality for Graves’ hyperthyroidism should be taken into account during the physician-patient discussion to select the primary treatment. Considering recent data about the long-term efficacy and safety of ATDs, it seems that the appropriate selection of Graves’ patients for long-term ATD therapy can be a new avenue in the treatment and even cure of GD.