Predicting Graves’ Relapse after Antithyroid Drug Treatment

If you're being treated with antithyroid drugs like PTU or Tapazole, is there a way to predict whether you'll have a relapse of Graves' disease? Experts are saying it's possible to look into the crystal ball, and here's how.

Polish researchers looked at the usefulness of measuring thyrotropin-binding inhibiting immunoglobulins (TBII) in predicting the possibility of relapse in the early phase of antithyroid drug treatment. In the study, patients taking methimazole for Graves’ disease were treated for 12 months. TSH, Free T4, Free T3, thyroid autoantibodies and TBII levels were measured at 1, 3, 6, 9 and 12 months of antithyroid drug treatment. Patients were followed up in the two to three years years after treatment.

Of the patients studied, 32% had a relapse of hyperthyroidism, typically occuring around 8 months after stopping the antithyroid drugs. The difference in TBII levels between the relapse and the remission group was found to be significant after the first month of therapy until the end of antithyroid drug treatment. The researchers found that patients with TBII above 14 after 3 months and above 8 after 6 months of therapy relapsed more frequently than patients with lower levels.

The researchers have concluded that measuring TBII in the early phase of antithyroid drug treatment could be useful in the proper planning of Graves’ disease therapy and could help in deciding whether to pursue more radical treatment, i.e., radioactive iodine or surgery.

Source: Jonas, M, et. al. “Predicting a relapse of Graves’ hyperthyroidism in adults during the early phase of treatment with anti-thyroid drugs.” Endokrynol Pol. 2006 Nov-Dec;57(6):596-604.

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