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Cited by 46Thyroid Disorders and TreatmentsOphthalmology and Eye DisordersThyroid and Parathyroid Surgery

Therapeutic effectiveness of potassium iodine in drug-naïve patients with Graves’ disease: a single-center experience

Uchida, Toyoyoshi, Goto, Hiromasa, Kasai, Takatoshi, Komiya, Koji, Takeno, Kageumi, Abe, Hiroko, Shigihara, Nayumi, Sato, Junko +5 more·2014·Endocrine
DOI 10.1007/s12020-014-0171-8
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Abstract

Iodine is beneficial against Graves' thyrotoxicosis, though its effects are short-lived. However, its long-term effectiveness as an initial therapy has not been fully elucidated. Here, we compared the effects of potassium iodine (KI) and methimazole (MMI) in Graves' thyrotoxicosis and on thyrotropin receptor antibody (TRAb) levels. Between 2008 and 2011, 293 patients with untreated Graves' disease visited the outpatient clinic of Juntendo University. Of these, 227 patients were treated with MMI and 30 treated with KI as the initial therapy. To compare the effects of KI and MMI, we identified patients with similar probabilities of receiving MMI or KI using propensity score (PS) analysis based on the observed clinical features. PS matching created 20 matched pairs of patients with Graves' disease treated with MMI and KI. The baseline characteristics of post-matched patients treated with MMI were comparable to those treated with KI (FT3; 7.16 ± 2.30, 6.56 ± 1.85 pg/ml, FT4; 2.57 ± 0.79, 2.49 ± 0.70 ng/dl, respectively). The initial dose of MMI was 14.0 ± 8.2 mg/day and that of KI was 53.6 ± 11.7 mg/day. Three patients of the KI group did not respond to the monotherapy, requiring the inclusion of antithyroid drugs. One patient on MMI developed moderate skin eruption, but continued the treatment. Patients who continued the initial treatment showed significant and comparable reductions in FT4, FT3 and TRAb by MMI as well as by KI at the end of 12-month treatment. Although patients were limited to mild untreated Graves' disease thyrotoxicosis, KI offers a possible alternative initial treatment for this condition.

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  • Recent studies have suggested a potential role for iodine in patients who have had adverse reactions to ATD and who also have a contraindication or aversion to RAI or surgery.

    “Recent studies have suggested a potential role for iodine in patients who have had adverse reactions to ATD and who also have a contraindication or aversion to RAI or surgery (243,244).”

    From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [244]

  • Among 20 Japanese patients with mild hyperthyroidism initially treated with KI alone and matched using propensity score analysis with patients treated with MMI alone, 85% of the patients treated with KI alone had normal thyroid function at 6 months and 1 year, comparable to that of the matched controls treated with MMI.

    “Among 20 Japanese patients with mild hyperthyroidism initially treated with KI alone and matched using propensity score analysis with patients treated with MMI alone, 85% of the patients treated with KI alone had normal thyroid function at 6 months and 1 year, comparable to that of the matched controls treated with MMI (244).”

    From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [244]

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Authors
Uchida, T., Goto, H., Kasai, T., Komiya, K., Takeno, K., Abe, H., Shigihara, N., Sato, J., Honda, A., Mita, T., Kanazawa, A., Fujitani, Y., & Watada, H.
Affiliations
Juntendo University (JP)
Corresponding author
Uchida, Toyoyoshi
ORCID
Venue
Endocrine
Publisher
Springer Science and Business Media LLC
Published
2014-02-04
Volume
47
Issue
2
Pages
506-511
ISSN
  • 0969-711X (ISSN-L)
  • 1355-008X
  • 1559-0100
DOI
10.1007/s12020-014-0171-8
OpenAlex
W2045480717
Cited by
46
References
26
Citations by year
2026: 6 · 2025: 5 · 2024: 5 · 2023: 4 · 2022: 3 · 2021: 1 · 2020: 6 · 2019: 1 · 2018: 2 · 2017: 6 · 2016: 4 · 2015: 2 · 2014: 1
FWCI
3.48
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • Endocrine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Ophthalmology and Eye Disorders
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
Keywords
Graves' disease, potassium iodide, methimazole, drug-naive patients, TSH receptor antibodies, thyrotoxicosis, free thyroxine, free triiodothyronine, antithyroid drug adverse effects, propensity score matching
MeSH terms
Adult, Aged, Female, Graves Disease, Humans, Male, Methimazole, Middle Aged, Potassium Iodide, Antithyroid Agents, Treatment Outcome, Young Adult

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