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Therapeutic effectiveness of potassium iodine in drug-naïve patients with Graves’ disease: a single-center experience

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Abstract

Iodine is beneficial against Graves’ thyrotoxicosis, though its effects are short-lived. However, its long-term effectiveness as an initial therapy has not been fully elucidated. Here, we compared the effects of potassium iodine (KI) and methimazole (MMI) in Graves’ thyrotoxicosis and on thyrotropin receptor antibody (TRAb) levels. Between 2008 and 2011, 293 patients with untreated Graves’ disease visited the outpatient clinic of Juntendo University. Of these, 227 patients were treated with MMI and 30 treated with KI as the initial therapy. To compare the effects of KI and MMI, we identified patients with similar probabilities of receiving MMI or KI using propensity score (PS) analysis based on the observed clinical features. PS matching created 20 matched pairs of patients with Graves’ disease treated with MMI and KI. The baseline characteristics of post-matched patients treated with MMI were comparable to those treated with KI (FT3; 7.16 ± 2.30, 6.56 ± 1.85 pg/ml, FT4; 2.57 ± 0.79, 2.49 ± 0.70 ng/dl, respectively). The initial dose of MMI was 14.0 ± 8.2 mg/day and that of KI was 53.6 ± 11.7 mg/day. Three patients of the KI group did not respond to the monotherapy, requiring the inclusion of antithyroid drugs. One patient on MMI developed moderate skin eruption, but continued the treatment. Patients who continued the initial treatment showed significant and comparable reductions in FT4, FT3 and TRAb by MMI as well as by KI at the end of 12-month treatment. Although patients were limited to mild untreated Graves’ disease thyrotoxicosis, KI offers a possible alternative initial treatment for this condition.

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Abbreviations

GD:

Graves’ disease

FT3:

Free triiodothyronine

FT4:

Free thyroxine

KI:

Potassium iodide

MMI:

Methimazole

PS:

Propensity score

STA-PSV:

Mean peak systolic velocity of superior thyroid artery

TSH:

Thyrotropin

TRAb:

Thyrotropin receptor antibody

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Acknowledgments

The authors thank Noriko Iijima and Emi Ito for the excellent technical assistance.

Conflicts of interest

TK has research funds from Philips-Respironics, Teijin Home Healthcare, Fukuda Denshi. TM has research funds from Eli Lilly, Takeda Pharmaceutical Co., MSD. AK has received lecture fees from Takeda Pharmaceutical Co., Sanofi-Aventis. YF has lecture fees from Novartis Pharmaceuticals, Eli Lilly and research funds from Eli Lilly, Takeda Pharmaceutical Co., MSD. HW has received lecture fees from Boehringer Ingelheim, Sanofi-Aventis, Ono Pharmaceutical Co., Novo Nordisk Pharma, Novartis Pharmaceuticals, Eli Lilly, Sanwakagaku Kenkyusho, Daiichi Sankyo Inc., Takeda Pharmaceutical Co., MSD, Dainippon Sumitomo Pharm., Kowa Co. and research funds from Boehringer Ingelheim, Pfizer, Mochida Pharmaceutical Co. Sanofi-Aventis, Novo Nordisk Pharma, Novartis Pharmaceuticals, Sanwakagaku Kenkyusho, Terumo Corp. Eli Lilly, Mitsubishi Tanabe Pharma, Daiichi Sankyo Inc., Takeda Pharmaceutical Co., MSD, Shionogi, Pharma, Dainippon Sumitomo Pharma, Kissei Pharma, and Astrazeneca.

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Authors and Affiliations

  1. Department of Medicine, Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan

    Toyoyoshi Uchida, Hiromasa Goto, Koji Komiya, Kageumi Takeno, Hiroko Abe, Nayumi Shigihara, Junko Sato, Akira Honda, Tomoya Mita, Akio Kanazawa, Yoshio Fujitani & Hirotaka Watada

  2. Cardio-Respiratory Sleep Medicine, Department of Cardiology, Juntendo University Graduate School, Bunkyo-ku, Tokyo, 113-8421, Japan

    Takatoshi Kasai

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  1. Toyoyoshi Uchida
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  2. Hiromasa Goto
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  3. Takatoshi Kasai
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Correspondence to Toyoyoshi Uchida.

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Uchida, T., Goto, H., Kasai, T. et al. Therapeutic effectiveness of potassium iodine in drug-naïve patients with Graves’ disease: a single-center experience. Endocrine 47, 506–511 (2014). https://doi.org/10.1007/s12020-014-0171-8

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  • DOI: https://doi.org/10.1007/s12020-014-0171-8

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