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The longer the antithyroid drug is used, the lower the relapse rate in Graves’ disease: a retrospective multicenter cohort study in Korea

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Abstract

Purpose

Current literature suggests 12–18 months of antithyroid drug (ATD) treatment for patients with Graves’ disease, but the risk of relapse is high. Although some studies reported better outcomes of long-term ATD treatment, recent data that suggest the optimal treatment duration are limited.

Methods

We performed a multicenter retrospective cohort study of 908 patients newly diagnosed with Graves’ disease between 2006 and 2013. The relapse rate according to ATD treatment duration was analyzed.

Results

After initial ATD treatment, 338 patients (37.2%) had relapsed. The relapse rate according to ATD treatment duration was 42.4% at 1 year, 38.5% at 2 years, 33.8% at 3 years, 31.7% at 4 years, 30.2% at 5 years, 27.8% at 6 years, and 19.1% at more than 6 years, respectively, demonstrating a significant decreasing trend (p = 0.003). In a multivariable Cox regression analysis, ATD treatment duration was an independent risk factor for relapse (p = 0.043).

Conclusions

The longer that ATD therapy is used, the lower the relapse rate is in patients with Graves’ disease. Long-term ATD treatment may be considered in Graves’ patients who do not show complications or an economic burden from hyperthyroidism.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors thank the Biostatistics Department of Samsung Biomedical Research Institute for its statistical assistance.

Funding

This work was supported by the Korean Thyroid Association Clinical Research Award 2018 and the Samjung Scholarship Foundation.

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Author notes

  1. These authors contributed equally: So Young Park, Bo Hyun Kim

  2. These authors jointly supervised this work: Ho-Cheol Kang, Jae Hoon Chung

Authors and Affiliations

  1. Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    So Young Park, Jun Park, Hyunju Park, Min Sun Choi, Tae Hyuk Kim, Sun Wook Kim & Jae Hoon Chung

  2. Division of Endocrinology, Department of Medicine, Korea University Ansan Hospital, Ansan, Korea

    So Young Park

  3. Division of Endocrinology and Metabolism, Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea

    Bo Hyun Kim & Mijin Kim

  4. Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea

    A.Ram Hong & Ho-Cheol Kang

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Contributions

S.Y.P. and B.H.K. analyzed data and wrote the first draft of the manuscript, and contributed equally to this work. M.K., A.R.H., J.P., and H.P. were involved in the data collection. M.S.C. analyzed the data. T.H.K. and S.W.K. revised the manuscript for important intellectual content. H.C.K. and J.H.C. designed the study and analyzed data, and contributed equally to this work. All authors contributed to the interpretation of the results and approved the final version of the manuscript.

Corresponding authors

Correspondence to Ho-Cheol Kang or Jae Hoon Chung.

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Conflict of interest

The authors declare no competing interests.

Ethical approval

This study protocol was approved by the Institutional Review Boards of SMC (No. 2019-02-106), PNUH (No. 1907-009-080), and CNUHH (No. 2019-123).

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Patient consent was waived in some instances by the Institutional Review Boards Committee, because of the retrospective chart review study design and use of only deidentified clinicopathological information.

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Park, S.Y., Kim, B.H., Kim, M. et al. The longer the antithyroid drug is used, the lower the relapse rate in Graves’ disease: a retrospective multicenter cohort study in Korea. Endocrine 74, 120–127 (2021). https://doi.org/10.1007/s12020-021-02725-x

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