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JYMS : Journal of Yeungnam Medical Science

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Hyo-Jeong Kim 1 Article
Long-term management of Graves disease: a narrative review
Hyo-Jeong Kim
J Yeungnam Med Sci. 2023;40(1):12-22.   Published online November 4, 2022
DOI: https://doi.org/10.12701/jyms.2022.00444
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  • 3 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Graves disease (GD) is the most common cause of hyperthyroidism, accounting for more than 90% of cases in Korea. Patients with GD are treated with any of the following: antithyroid drugs (ATDs), radioactive iodine (RAI) therapy, or thyroidectomy. Most patients begin treatment with ATDs, and clinical guidelines suggest that the appropriate treatment period is 12 to 18 months. While RAI treatment and surgery manage thyrotoxicosis by destroying or removing thyroid tissue, ATDs control thyrotoxicosis by inhibiting thyroid hormone synthesis and preserving the thyroid gland. Although ATDs efficiently control thyrotoxicosis symptoms, they do not correct the main etiology of GD; therefore, frequent relapses can follow. Recently, a large amount of data has been collected on long-term ATDs for GD, and low-dose methimazole (MMZ) is expected to be a good option for remission. For the long-term management of recurrent GD, it is important to induce remission by evaluating the patient’s drug response, stopping ATDs at an appropriate time, and actively switching to surgery or RAI therapy, if indicated. Continuing drug treatment for an extended time is now encouraged in patients with a high possibility of remission with low-dose MMZ. It is also important to pay attention to the quality of life of the patients. This review aimed to summarize the appropriate treatment methods and timing of treatment transition in patients who relapsed several times while receiving treatment for GD.

Citations

Citations to this article as recorded by  
  • Commentary: Azathioprine as an adjuvant therapy in severe Graves’ disease: a randomized controlled open-label clinical trial
    Madhukar Mittal, Azher Rizvi
    Frontiers in Endocrinology.2024;[Epub]     CrossRef
  • Total Thyroidectomy – A Cost-effective Alternative to Anti-Thyroid Drugs in the Management of Grave's Disease
    Erivelto Volpi, Leonardo M. Volpi
    Clinical Thyroidology.2023; 35(5): 183.     CrossRef
  • Evaluation of the Abbott Alinity i Thyroid-Stimulating Hormone Receptor Antibody (TRAb) Chemiluminescent Microparticle Immunoassay (CMIA)
    Deborah J. W. Lee, Soon Kieng Phua, Yali Liang, Claire Chen, Tar-Choon Aw
    Diagnostics.2023; 13(16): 2707.     CrossRef
  • Mechanisms and Treatment Options for Hyperthyroid-Induced Osteoporosis: A Narrative Review
    Robert M Branstetter, Rahib K Islam, Collin A Toups, Amanda N Parra, Zachary Lee, Shahab Ahmadzadeh, Giustino Varrassi, Sahar Shekoohi, Alan D Kaye
    Cureus.2023;[Epub]     CrossRef

JYMS : Journal of Yeungnam Medical Science