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Treatment of post-radioactive iodine relapse of hyperthyroidism: comparison of long-term methimazole and radioactive iodine treatment

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Abstract

Background

This study aimed to compare the time to achieve euthyroidism and sustained control of hyperthyroidism after treatment with radioactive iodine (RAI) or long-term methimazole (LT-MMI) in patients with post-RAI relapsed hyperthyroidism.

Methods

Sixty four patients with recurrence of hyperthyroidism after RAI treatment were randomly assigned to either RAI or LT-MMI treatment. Both groups were followed every 1–3 months in the first year and then every 6 months for a total of 60 months.

Results

In RAI and LT-MMI groups, mean age was 49.0 ± 12.1 and 50.1 ± 14.6 years and time of relapse of hyperthyroidism after previous RAI treatment was 23.2 ± 18.8 and 20.8 ± 17.1 months, respectively. At the end of study, in the LT-MMI group, 31 (97%) and 1 (3%) were euthyroid and hypothyroid, respectively; in the RAI group, 8 (25%) patients were euthyroid, whereas 18 (56%), 3 (9.5%) and 3 (9.5%) had overt hypothyroidism, subclinical hypothyroidism and hyperthyroidism, respectively. Mean time to euthyroidism was 9.4 ± 5.0 months in the RAI group and 3.5 ± 2.8 months in the LT-MMI group (p < 0.001). Patients in the RAI group spent 77.7 ± 14.0 percent and those in the LT-MMI group spent 95.2 ± 5.9 percent of 60 months in the euthyroid state (p < 0.001).

Conclusion

In patients with post-RAI relapse of hyperthyroidism, LT-MMI treatment was superior to radioiodine because of faster achievement of euthyroidism and more sustained control of hyperthyroidism during 60 months of follow-up.

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Acknowledgements

We wish to acknowledge Ms. Tahereh Fakhimi-Ata for her secretary role during manuscript preparation.

Funding

This study was supported in part by Grant No 22198–1 from Shahid Beheshti University of Medical Sciences.

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Author notes

  1. Fereidoun Azizi and Navid Saadat are co-first authors.

Authors and Affiliations

  1. Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    N. Saadat

  2. Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box, 19395-4763, Tehran, Islamic Republic of Iran

    F. Azizi, H. Abdi & A. Amouzegar

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  1. N. Saadat
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  2. F. Azizi
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  3. H. Abdi
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  4. A. Amouzegar
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Correspondence to A. Amouzegar.

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Saadat, N., Azizi, F., Abdi, H. et al. Treatment of post-radioactive iodine relapse of hyperthyroidism: comparison of long-term methimazole and radioactive iodine treatment. J Endocrinol Invest 45, 1919–1924 (2022). https://doi.org/10.1007/s40618-022-01823-5

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  • DOI: https://doi.org/10.1007/s40618-022-01823-5

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