Antithyroid drug therapy of Graves’ hyperthyroidism: realistic goals and focus on evidence

Abstract

Only a minority of patients with hyperthyroidism caused by Graves' disease will experience cure of disease with a permanent euthyroid state without medication. Antithyroid drugs are useful in attaining euthyroidism, and most patients will gradually enter remission of the autoimmune abnormality after becoming euthyroid. A stable euthyroid state may be sustained by prolonged low-dose medication. The risk of relapse of hyperthyroidism after withdrawal of medication seems to be independent of duration of therapy, once remission has been induced. A number of risk factors influence the outcome of therapy and they should be evaluated when planning duration of therapy with antithyroid drugs.

Keywords::

• carbimazole
• Graves’ disease
• methimazole
• propylthiouracil
• radioiodine therapy
• thyroid surgery