Post-partum and non-post-partum relapsing Graves' hyperthyroidism display different response to anti-thyroid drugs

Mario Rotondi, Valentina Capelli, Francesca Coperchini, Sara Pinto, Laura Croce, Massimo Tonacchera, Luca Chiovato

Research output: Contribution to journalArticle

Abstract

DESIGN: Graves' disease (GD) patients in remission after a full course of methimazole (MMI) therapy are at risk for a relapse of hyperthyroidism during the post-partum (PP) period, but whether this relapse may display any peculiarity is still unknown. Aim of this study was to compare GD patients undergoing a relapse of hyperthyroidism either in the PP period or not.

METHODS: We retrospectively evaluated forty-three GD female patients in their childbearing age who experienced a relapse of hyperthyroidism. Eighteen of them relapsed in the PP period (i.e. within 12 months after delivery, PP group); the remaining 25 relapsed elsewhere during life (NPP group).

RESULTS: Age at relapse, thyroid volume, thyroid function tests, TRAb titers, smoking habit, presence and degree of orbitopathy and duration of methimazole (MMI) treatment did not differ in the two groups. However, the remission rate was much greater (79%) in the PP as compared with the NPP (32%) group (P = 0.002). A significant reduction in TRAb levels occurred at 12-month MMI treatment in the PP (F = 9.016; P = 0.001), but not in the NPP group (F = 2.433; NS). At 12 months, the PP group had significantly lower mean TRAb levels (0.6 ± 1.1 U/L and 4.5 ± 4.7 U/L in the PP and the NPP group, respectively; P = 0.029).

CONCLUSIONS: Relapsing Graves' hyperthyroidism in the PP period is more prone to undergo a remission after a second course of MMI treatment. In these patients, a conservative therapeutic approach is more appropriate.

Original languageEnglish
Pages (from-to)589-594
Number of pages6
JournalEuropean Journal of Endocrinology
Volume178
Issue number6
DOIs
Publication statusPublished - Jun 2018

Fingerprint

Hyperthyroidism
Thyroid Gland
Graves Disease
Recurrence
Methimazole
Pharmaceutical Preparations
Therapeutics
Thyroid Function Tests
Habits
Smoking

Keywords

  • Adult
  • Antithyroid Agents/therapeutic use
  • Female
  • Graves Disease/blood
  • Humans
  • Methimazole/administration & dosage
  • Postpartum Period/physiology
  • Recurrence
  • Remission Induction
  • Retrospective Studies
  • Thyroid Function Tests
  • Thyroid Hormones/blood

Cite this

Post-partum and non-post-partum relapsing Graves' hyperthyroidism display different response to anti-thyroid drugs. / Rotondi, Mario; Capelli, Valentina; Coperchini, Francesca; Pinto, Sara; Croce, Laura; Tonacchera, Massimo; Chiovato, Luca.

In: European Journal of Endocrinology, Vol. 178, No. 6, 06.2018, p. 589-594.

Research output: Contribution to journalArticle

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title = "Post-partum and non-post-partum relapsing Graves' hyperthyroidism display different response to anti-thyroid drugs",
abstract = "DESIGN: Graves' disease (GD) patients in remission after a full course of methimazole (MMI) therapy are at risk for a relapse of hyperthyroidism during the post-partum (PP) period, but whether this relapse may display any peculiarity is still unknown. Aim of this study was to compare GD patients undergoing a relapse of hyperthyroidism either in the PP period or not.METHODS: We retrospectively evaluated forty-three GD female patients in their childbearing age who experienced a relapse of hyperthyroidism. Eighteen of them relapsed in the PP period (i.e. within 12 months after delivery, PP group); the remaining 25 relapsed elsewhere during life (NPP group).RESULTS: Age at relapse, thyroid volume, thyroid function tests, TRAb titers, smoking habit, presence and degree of orbitopathy and duration of methimazole (MMI) treatment did not differ in the two groups. However, the remission rate was much greater (79{\%}) in the PP as compared with the NPP (32{\%}) group (P = 0.002). A significant reduction in TRAb levels occurred at 12-month MMI treatment in the PP (F = 9.016; P = 0.001), but not in the NPP group (F = 2.433; NS). At 12 months, the PP group had significantly lower mean TRAb levels (0.6 ± 1.1 U/L and 4.5 ± 4.7 U/L in the PP and the NPP group, respectively; P = 0.029).CONCLUSIONS: Relapsing Graves' hyperthyroidism in the PP period is more prone to undergo a remission after a second course of MMI treatment. In these patients, a conservative therapeutic approach is more appropriate.",
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author = "Mario Rotondi and Valentina Capelli and Francesca Coperchini and Sara Pinto and Laura Croce and Massimo Tonacchera and Luca Chiovato",
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T1 - Post-partum and non-post-partum relapsing Graves' hyperthyroidism display different response to anti-thyroid drugs

AU - Rotondi, Mario

AU - Capelli, Valentina

AU - Coperchini, Francesca

AU - Pinto, Sara

AU - Croce, Laura

AU - Tonacchera, Massimo

AU - Chiovato, Luca

N1 - © 2018 European Society of Endocrinology.

PY - 2018/6

Y1 - 2018/6

N2 - DESIGN: Graves' disease (GD) patients in remission after a full course of methimazole (MMI) therapy are at risk for a relapse of hyperthyroidism during the post-partum (PP) period, but whether this relapse may display any peculiarity is still unknown. Aim of this study was to compare GD patients undergoing a relapse of hyperthyroidism either in the PP period or not.METHODS: We retrospectively evaluated forty-three GD female patients in their childbearing age who experienced a relapse of hyperthyroidism. Eighteen of them relapsed in the PP period (i.e. within 12 months after delivery, PP group); the remaining 25 relapsed elsewhere during life (NPP group).RESULTS: Age at relapse, thyroid volume, thyroid function tests, TRAb titers, smoking habit, presence and degree of orbitopathy and duration of methimazole (MMI) treatment did not differ in the two groups. However, the remission rate was much greater (79%) in the PP as compared with the NPP (32%) group (P = 0.002). A significant reduction in TRAb levels occurred at 12-month MMI treatment in the PP (F = 9.016; P = 0.001), but not in the NPP group (F = 2.433; NS). At 12 months, the PP group had significantly lower mean TRAb levels (0.6 ± 1.1 U/L and 4.5 ± 4.7 U/L in the PP and the NPP group, respectively; P = 0.029).CONCLUSIONS: Relapsing Graves' hyperthyroidism in the PP period is more prone to undergo a remission after a second course of MMI treatment. In these patients, a conservative therapeutic approach is more appropriate.

AB - DESIGN: Graves' disease (GD) patients in remission after a full course of methimazole (MMI) therapy are at risk for a relapse of hyperthyroidism during the post-partum (PP) period, but whether this relapse may display any peculiarity is still unknown. Aim of this study was to compare GD patients undergoing a relapse of hyperthyroidism either in the PP period or not.METHODS: We retrospectively evaluated forty-three GD female patients in their childbearing age who experienced a relapse of hyperthyroidism. Eighteen of them relapsed in the PP period (i.e. within 12 months after delivery, PP group); the remaining 25 relapsed elsewhere during life (NPP group).RESULTS: Age at relapse, thyroid volume, thyroid function tests, TRAb titers, smoking habit, presence and degree of orbitopathy and duration of methimazole (MMI) treatment did not differ in the two groups. However, the remission rate was much greater (79%) in the PP as compared with the NPP (32%) group (P = 0.002). A significant reduction in TRAb levels occurred at 12-month MMI treatment in the PP (F = 9.016; P = 0.001), but not in the NPP group (F = 2.433; NS). At 12 months, the PP group had significantly lower mean TRAb levels (0.6 ± 1.1 U/L and 4.5 ± 4.7 U/L in the PP and the NPP group, respectively; P = 0.029).CONCLUSIONS: Relapsing Graves' hyperthyroidism in the PP period is more prone to undergo a remission after a second course of MMI treatment. In these patients, a conservative therapeutic approach is more appropriate.

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KW - Antithyroid Agents/therapeutic use

KW - Female

KW - Graves Disease/blood

KW - Humans

KW - Methimazole/administration & dosage

KW - Postpartum Period/physiology

KW - Recurrence

KW - Remission Induction

KW - Retrospective Studies

KW - Thyroid Function Tests

KW - Thyroid Hormones/blood

U2 - 10.1530/EJE-17-1063

DO - 10.1530/EJE-17-1063

M3 - Article

C2 - 29559498

VL - 178

SP - 589

EP - 594

JO - European Journal of Endocrinology

JF - European Journal of Endocrinology

SN - 0804-4643

IS - 6

ER -