Antithyroid Drugs
Abstract
Antithyroid drugs, which have been available for more than half a century, are important in the management of hyperthyroidism, particularly in patients with Graves' disease, who have a high response rate. Since the responses of patients vary and these agents have potentially serious side effects, a working knowledge of their complex pharmacology is required. This review article considers recent pharmacologic and clinical data related to the use of these compounds.
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Some patients may develop a transient increase in thyroid hormones after RAI.
“Some patients may develop a transient increase in thyroid hormones after RAI [115, 117] .”
From The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism (2015) · cites this paper as [115]
ATDs are associated with a variety of side effects that include rare but potentially life-threatening complications.
“ATDs are associated with a variety of side effects that include rare but potentially life-threatening complications [4,115,116] .”
From The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism (2015) · cites this paper as [115]
Hepatocellular disease is rarely reported during MMI treatment.
“Hepatocellular disease is rarely reported during MMI treatment [115, 117] .”
From The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism (2015) · cites this paper as [115]
Block and replace therapy is not generally recommended because it has been shown to result in a higher rate of ATD side effects.
“However, this approach is not generally recommended because it has been shown to result in a higher rate of ATD side effects (109,119).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [109]
Remission rates of Graves' disease are highest in persons with mild disease.
“since remission rates are highest in persons with mild disease (109).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [109]
MMI and PTU both appear in breast milk in only small concentrations, and studies of breastfed infants of mothers taking antithyroid drugs have demonstrated normal thyroid function and subsequent normal intellectual development.
“MMI and PTU both appear in breast milk in only small concentrations, and studies of breastfed infants of mothers taking ATDs have demonstrated normal thyroid function and subsequent normal intellectual development (109).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [109]
Both MMI and PTU are effective therapies of hyperthyroidism in the majority of patients, and the major effect of both drugs is interaction with thyroid peroxidase-catalyzed thyroid hormone production.
“Both MMI and PTU are effective therapies of hyperthyroidism in the majority of patients, and the major effect of both drugs is interaction with thyroid peroxidase-catalyzed thyroid hormone production (109).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [109]
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- Authors
- Cooper, D. S.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Cooper, David S.
- ORCID
- Cooper, David S.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2005-03-03
- Volume
- 352
- Issue
- 9
- Pages
- 905-917
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W4243225672
- Cited by
- 1,008
- References
- 123
- Citations by year
- 2026: 35 · 2025: 36 · 2024: 51 · 2023: 50 · 2022: 45 · 2021: 52 · 2020: 62 · 2019: 38 · 2018: 62 · 2017: 51 · 2016: 66 · 2015: 51 · 2014: 48 · 2013: 56 · 2012: 49
- FWCI
- 4.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Pathology and Forensic Medicine › Ophthalmology and Eye Disorders
- Keywords
- antithyroid drugs, hyperthyroidism, Graves' disease, adverse effects, drug response
- MeSH terms
- Agranulocytosis, Algorithms, Female, Graves Disease, Humans, Hyperthyroidism, Methimazole, Pregnancy, Pregnancy Complications, Propylthiouracil, Antithyroid Agents, Thyroid Gland, Thyrotoxicosis, Thyroxine, Triiodothyronine
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