Effect of pretreatment with antithyroidal drugs on the failure rate of radioiodine therapy in Graves' disease Journal Article

  


Author: Tuttle, R. M.
Article Title: Effect of pretreatment with antithyroidal drugs on the failure rate of radioiodine therapy in Graves' disease
Abstract: Radioactive iodine is now widely used as definitive therapy for Graves' Disease. As part of routine clinical practice, many physicians recommend pretreatment with antithyroidal medications for several weeks prior to radioactive iodine therapy in an effort to minimize any risk of precipitating thyroid storm. Recently, several studies have failed to demonstrate any clinically significant changes in serum thyroid hormone levels immediately following RAI administration. Furthermore, pretreatment with antithyroidal drugs, even when discontinued for several days before RAI administration, has been reported to result in a significant decrease in the effectiveness of RAI. A careful analysis of the data reveals that propylthiouracil, but not methimizole, has significant radioprotective properties when used as pretreatment before RAI dosing. Since radioactive iodine therapy can be safely administered following adequate beta-adrenergic blockade in most patients, these data question the rationale for routine use of antithyroidal drug therapy before RAI therapy. This review carefully analyzes the available data concerning the effect of pretreatment with antithyroidal medications on the failure rate of subsequent RAI therapy in Graves' Disease.
Keywords: treatment outcome; review; drug efficacy; treatment planning; drug structure; drug effect; radioactive iodine; drug mechanism; drug metabolism; antithyroid agent; beta adrenergic receptor blocking agent; thyroid hormone; radiation protection; propylthiouracil; thiamazole; graves disease; thyroid hormone blood level; human; carbimazole; thiourea derivative; thyroid crisis
Journal Title: Endocrinologist
Volume: 10
Issue: 6
ISSN: 1051-2144
Publisher: Lippincott Williams & Wilkins  
Date Published: 2000-11-01
Start Page: 403
End Page: 411
Language: English
PROVIDER: scopus
DOI/URL:

http://www.scopus.com/inward/record.url?eid=2-s2.0-0034537066&partnerID=40&md5=90b2cce5c1efedaa70f43b26c22818cf
Notes: Export Date: 18 November 2015 -- Source: Scopus