does long term ATD benefit?

[Guest guest]

PTU and Tapzole have been around for a quite long time. There are

many many studies on the duration people should take to achieve

remission without relapse. here is an abstract from Japan.

It might provide a bit more information.

Best wishes!

Liang

Endocrinol Jpn. 1991 Apr;38(2):223-7. Related Articles, Links

Antithyroid drug therapy for Graves' hyperthyroidism: is long-term

administration of a small maintenance dose necessary?

Tajiri J, Noguchi S, Morita M, Tamaru M, Murakami N.

Noguchi Thyroid Clinic and Hospital Foundation, Oita, Japan.

This retrospective study serves as an inquiry into the common

practice of long-term administration of small maintenance doses of

either methyl-mercaptoimidazole (MMI) or propylthiouracil (PTU) to

Graves' hyperthyroid patients who became euthyroid with primary

large doses of the same drugs. One hundred and two patients with

Graves' hyperthyroidism treated with antithyroid drug (ATD) were

studied. Sixty-one were treated with conventional long term therapy

and 41 were treated with short-term therapy. Small maintenance doses

of ATDs were not administered to the short-term therapy patients.

The duration of long-term therapy was 28.6 +/- 20.2 months (from 12

to 48 months) and that of short-term therapy was 8.4 +/- 1.8 months

(from 5 to 11). Post therapy and follow-up observation continued for

19.0 +/- 2.7 months (16-25 months) in both long-term and short-term

patients. Of the 61 long-term therapy patients, 20 were relapsed and

41 (67.2%) continue to remain in remission. So too, of the 41 short-

term therapy patients, 14 relapsed and 27 (65.9%) still remain in

remission. There was no statistical difference between the long-term

and short-term therapy group in age, sex, duration of symptoms

before diagnosis, antithyroid antibodies, radioactive iodine uptake,

free thyroid hormone levels or goiter size before treatment or in

TBII levels at cessation of ATD. It is concluded that 'short-term

ATD therapy' without a maintenance dose is sufficient and saves

several months of the patient's and clinician's time.

[Guest guest]

> Endocrinol Jpn. 1991 Apr;38(2):223-7. Related Articles, Links

>

> Antithyroid drug therapy for Graves' hyperthyroidism: is long-term

> administration of a small maintenance dose necessary?

I find all this fascinating. I don't have internet access and I would

otherwise have been too intimidated to think of tackling these kinds of

works. And yet once they're handed to me I find them accessible enough

that I can even make a few intelligent comments ;-)

- The study doesn't mention if TSI was tested at all.

- The study doesn't mention how the ATD was administered. I suspect it

was administered PROPERLY - starting at a presumably appropriately high

dose and gradually lowered. One of the dialogues quack endos employ goes

like this:

Dr. (dismissing ATDs): Noone uses ATDs anymore; ATD use is down

everywhere.

Patient: In Japan they use ATDs with what I've heard is respectable

success.

Dr: Yeah, but thanks to the bomb they're leery of it over there. But it's

changing there too.

So while radioactivity for medical treatments may be gaining ground, for

now, Japanese endocrinologists still have more of a handle on ATD use

than their American counterparts.

Take care, Fay

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