The DOI matches its Crossref record; 31 of the 31 references it cites were found in a registry or an index.
Comparative Effectiveness of Therapies for Graves' Hyperthyroidism: A Systematic Review and Network Meta-Analysis
Open accessAbstract
CONTEXT: Several treatment options are available for Graves' disease (GD), including antithyroid drugs (ATDs), radioactive iodine (RAI), and thyroidectomy. OBJECTIVE: The primary outcome was to determine the relapse rates of various treatment options. The secondary outcome was to present data regarding adverse effects of ATDs. DATA SOURCES: We searched multiple databases through March 2012. STUDY SELECTION: Eligible studies were randomized clinical trials and comparative cohort studies in adults that included 2 or more treatment options for GD. DATA EXTRACTION: Two reviewers independently selected studies, appraised study quality, extracted outcome data, and determined adverse effect profiles. DATA SYNTHESIS: We found 8 studies with 1402 patients from 5 continents. Mean follow-up duration in months was: ATDs, 57; RAI, 64; and surgery, 59. Studies were at moderate to high risk of bias. Network meta-analysis suggested higher relapse rates with ATDs (52.7%; 352 of 667) than RAI (15%, 46 of 304) (odds ratio = 6.25; 95% confidence interval, 2.40-16.67) and with ATDs than surgery (10%; 39 of 387) (odds ratio = 9.09; 95% confidence interval, 4.65-19.23). There was no significant difference in relapse between RAI and surgery. Examination of 31 cohort studies identified adverse effects of ATDs in 692 of 5136 (13%) patients. These were more common with methimazole, mainly owing to dermatological complications, whereas hepatic effects were more common with propylthiouracil use. CONCLUSION: We confirm the relatively high relapse rate of ATD therapy in comparison with RAI or surgery, along with a significant side effect profile for these drugs. These data can inform discussion between physicians and patients regarding the choice of therapy for GD. The limited quality of the evidence in the literature underlines the need for future randomized clinical trials in this area.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“In a recent systematic review of eight studies that included 667 GD patients receiving MMI or PTU, 13% of patients experienced adverse events (122).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [122]
In the citing paper
“Hepatocellular injury occurred in 2.7% of patients taking PTU and 0.4% of patients taking MMI.”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [122]
In the citing paper
“The minor allergic reactions included pruritus or a limited, minor rash in 6% of patients taking MMI and 3% of patients taking PTU (122).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [122]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement.
(2009) · PubMed Central · Cited by 44,859
Meta-analysis in clinical trials
DerSimonian, R., & Laird, N. (1986) · Controlled Clinical Trials · doi:10.1016/0197-2456(86)90046-2 · Cited by 39,552
Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & the PRISMA Group* (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-151-4-200908180-00135 · Cited by 37,554
The Cochrane Collaboration's tool for assessing risk of bias in randomised trials
Higgins, J. P. T., Altman, D. G., Gotzsche, P. C., Juni, P., Moher, D., Oxman, A. D., Savovic, J., Schulz, K. F., Weeks, L., Sterne, J. A. C., et al. (2011) · BMJ · doi:10.1136/bmj.d5928 · Cited by 33,817
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement
Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2009.06.005 · Cited by 19,575
(2014) · Medical Entomology and Zoology · Cited by 17,633
Thyroid hormone and the cardiovascular system.
Klein, I., & Ojamaa, K. (2001) · New England Journal of Medicine · doi:10.1056/nejm200102153440707 · Cited by 2,300
Empirical assessment of effect of publication bias on meta-analyses
Sutton, A. J. (2000) · BMJ · doi:10.1136/bmj.320.7249.1574 · Cited by 1,398
Network meta‐analysis for indirect treatment comparisons
Lumley, T. (2002) · Statistics in Medicine · doi:10.1002/sim.1201 · Cited by 1,206
Flagged first, then by citations
Cited by
Sorted by citations
Items 201–249 of 249
Antithyroid drug therapy for Graves’ disease
Shin, S. M., & Yi, K. H. (2021) · Journal of Korean Medical Association · doi:10.5124/jkma.2021.64.10.690
Aeromedical Decision Making for Military Aircrew with Graves’ Disease
Loh, E. H.-T., Soh, F. W., See, B., & Tan, B. B. C. (2021) · Aerospace Medicine and Human Performance · doi:10.3357/amhp.5885.2021
Maurer, E., & Holzer, K. (2021) · Springer Reference Medizin · doi:10.1007/978-3-662-61724-3_9-1
Predictive Value of TRAb in the Early Drug Treatment of GD
陶, 玥. (2021) · Advances in Clinical Medicine · doi:10.12677/acm.2021.1112862
Bartalena, L. (2016) · Endocrinology · doi:10.1007/978-3-319-29195-6_17-1
(2021) · Elsevier eBooks · doi:10.1016/b978-3-437-21921-4.00246-4
Chng, C. L. (2018) · Springer eBooks · doi:10.1007/978-981-10-1124-5_2
Dios, P. D., Kumar, F. N., BSc, S. P., & Posse, M. J. L. (2022) · doi:10.1002/9781119600077.ch5.3
Incidence, treatments, and outcomes of Graves’ disease in Thailand: a single-center studyPreprint
Kanokwongnuwat, W. (2022) · Research Square · doi:10.21203/rs.3.rs-1527901/v1
Martins, J. M., Reis, D., Batista, L., Paramés, F., de Almeida, M. M., & Cantinho, G. (2019) · Journal of Endocrinology and Metabolism · doi:10.14740/jem550
Li, J. H., Kasid, N., & Hennessey, J. V. (2019) · Springer eBooks · doi:10.1007/978-3-319-72102-6_22
(2018) · Elsevier eBooks · doi:10.1016/b978-3-437-42502-8.16001-2
LaVine, N. (2018) · Springer eBooks · doi:10.1007/978-3-319-68379-9_8
Graves Disease (Diffuse Hyperplasia)
(2016) · Elsevier eBooks · doi:10.1016/b978-0-323-39255-6.50292-1
LaVine, N. (2022) · Springer eBooks · doi:10.1007/978-3-031-15353-2_8
Zhang, M., Lou, B., & Huang, W. (2023) · Research Square · doi:10.21203/rs.3.rs-2391421/v1
WOŚ, N., SZALA-CZERWONKA, K., Rejmer, A., ROJEK, K., BEDNARZ, L., WIJAS, K., Bialic, K., Bakalarczyk, R., BIALIC, A., & Majewski, P. (2023) · Journal of Education Health and Sport · doi:10.12775/jehs.2023.32.01.003
Does Vitamin D Supplementation Reduce Relapse of Graves' Disease?: The RCT We Needed
Kawkgi, O. M. E. (2023) · Clinical Thyroidology · doi:10.1089/ct.2023;35.268-271
Thyroid function test variability and cardiovascular morbidity in hyperthyroidism
Suonsyrjä, N., Laihia, I., Huhtala, H., Jaatinen, P., & Metso, S. (2023) · Clinical Endocrinology · doi:10.1111/cen.14948
Prediction of the recurrence risk of Graves' disease after antithyroid drug therapy
Qiang, Z., & Fu, Y. (2023) · Environmental Disease · doi:10.4103/ed.ed_23_22
Abd‐ElGawad, M., Abdelgalil, M. S., Abdelsattar, N. K., Salamah, H. M., & Kamel, M. A. (2023) · Research Square · doi:10.21203/rs.3.rs-3542960/v1
Diagnostic Considerations for Thyroid Nodules in Graves’ Disease
Hang, J. (2023) · Springer eBooks · doi:10.1007/978-981-99-6782-7_37
Surgery and RAI for Cardiovascular Event Reduction in Hyperthyroidism
Gao, T. P., & Kuo, L. E. Y. (2024) · Clinical Thyroidology · doi:10.1089/ct.2024;36.248-250
George, A., Mariya, A., Eappen, M., Karthikeyan, M., & Sreenath, R. (2024) · Journal of Pharmacy and Pharmacology · doi:10.1093/jpp/rgae073
Endocrinologia e Medicina Estética - Edição I
Freitas, G. B. L. D., & Vascão, E. (2024) · doi:10.59290/978-65-6029-140-9
Santos, S. L. D. M., de Mendonça, S. B., Nunes, Y. T., dos Santos, P. S., & Urias, C. F. D. A. (2024) · Brazilian Journal of Health Review · doi:10.34119/bjhrv7n4-443
Review of Surgical Interventions in the Thyroid Gland: Recent Advances and Current Considerations
Merino, N. H., & Vega, M. (2024) · Methods in molecular biology · doi:10.1007/978-1-0716-4252-8_14
Şengün, B. (2024) · SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital · doi:10.14744/semb.2024.74829
Matsuo, Y., & Yasunaga, H. (2025) · Critical Care Medicine · doi:10.1097/ccm.0000000000006469
Thyroid Imaging and Radionuclide Therapy
Aggarwal, P., Kaur, G., Sood, A. K., & Mittal, B. R. (2025) · Royal Society of Chemistry eBooks · doi:10.1039/9781837677139-00342
Three cases of methimazole-induced fever in patients with Graves’ hyperthyroidism
Koyama, I., Ohba, K., Kakizawa, K., Hashimoto, T., Tsuriya, D., Yamashita, M., & Matsushita, A. (2025) · Thyroid Science · doi:10.1016/j.thscie.2025.100031
Chaabouni, S., Meddeb, I., Somai, M., Krir, A., Mrad, M., Bahlous, A. H. S., & Mhiri, A. (2025) · Pan African Medical Journal · doi:10.11604/pamj.2025.52.87.49292
Hu, R.-T., & Li, B. (2025) · BMC Research Notes · doi:10.1186/s13104-025-07579-4
Mirjalili, S. R., Razmpoosh, E., Eshraghi, R., Ashoori, M., & Soltani, S. (2025) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgaf580 · Cited by 1
Yashmin, R., Ahmed, R., Begum, T., Kalita, J. C., Das, A., & Sarma, H. (2025) · Journal of Computational Biophysics and Chemistry · doi:10.1142/s2737416526500419 · Cited by 1
Wang, X., Li, T., Li, Y., Wang, Q., Cai, Y., Wang, Z., Shi, Y., Yang, T., & Zheng, X. (2024) · Figshare · doi:10.6084/m9.figshare.26699522
Self-citationThewjitcharoen, Y., Karndumri, K., Chatchomchuan, W., Porramatikul, S., Krittiyawong, S., Wanathayanoroj, E., Lekpittaya, N., Kittipoom, W., Tawee, A., Vongterapak, S., et al. (2021) · Figshare · doi:10.6084/m9.figshare.14157561
Wang, X., Li, T., Li, Y., Wang, Q., Cai, Y., Wang, Z., Shi, Y., Yang, T., & Zheng, X. (2024) · Figshare · doi:10.6084/m9.figshare.26699519
Self-citationAlsifri, S., Khader, S., Alzahrani, A., Almehthel, M., Almansari, A., Alhozali, A. M., Aljuhani, N. R., Jammah, A. A., Farahat, R., Elbadawi, H., et al. (2025) · International Journal of Clinical Medicine · doi:10.4236/ijcm.2025.169025
Taylor, P. N., Boelaert, K., & Witczak, J. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-13825-6.00327-7
Yuan, A., Yan, Z., Wu, J., Song, Y., & Huang, H. (2026) · Frontiers in Endocrinology · doi:10.3389/fendo.2026.1776734
Total Thyroidectomy for Severe Thyrotoxicosis in a Young Woman: A Case Report
Moreno, H. E. M., Guevara, U. S. S., Garcia, M. L. S., Ramírez, C. A. D., & Marta, B. G. V. (2026) · Cureus · doi:10.7759/cureus.107104
He, Y., Huang, D., & 杨天江 (2026) · Journal of Visualized Experiments · doi:10.3791/70516
Mossavarali, S., Vaezi, A., Sarvi, D. G., Mirdamadi, N., Mohseni, S., & Sani, M. P. (2026) · Research Square · doi:10.21203/rs.3.rs-9661309/v1
Risk of significant liver enzyme elevation after switching antithyroid drugs
Pollack, R. M., & Stokar, J. (2026) · European Journal of Endocrinology · doi:10.1093/ejendo/lvag123
Su, L., Guo, D., Su, B., Zhao, Z., Wang, J., Liu, M., Wei, M., & Ke, D. U. (2026) · Journal of Ethnopharmacology · doi:10.1016/j.jep.2026.122443
Dai, R., Li, M., 陈耀华, Wang, J., & 熊洪全 (2026) · Frontiers in Endocrinology · doi:10.3389/fendo.2026.1968560
Metadata
- Authors
- Sundaresh, V., Brito, J. P., Wang, Z., Prokop, L. J., Stan, M. N., Murad, M. H., & Bahn, R. S.
- Affiliations
- Mayo Clinic (US)
- Corresponding author
- Bahn, Rebecca S.
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2013-09
- Volume
- 98
- Issue
- 9
- Pages
- 3671-3677
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- PMC
- PMC3763977
- OpenAlex
- W1983002130
- Cited by
- 250
- References
- 31
- Citations by year
- 2026: 10 · 2025: 18 · 2024: 22 · 2023: 28 · 2022: 22 · 2021: 28 · 2020: 18 · 2019: 21 · 2018: 20 · 2017: 16 · 2016: 14 · 2015: 18 · 2014: 14 · 2013: 1
- FWCI
- 2.30
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Georgia Clinical and Translational Science Alliance (UL1 TR000135)
- National Institutes of Health (UL1TR000135, TR000135)
- National Center for Advancing Translational Sciences (CTSA Grant UL1 TR000135, TR000135)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Ophthalmology › Ophthalmology and Eye Disorders
- Keywords
- Graves' disease, Graves' hyperthyroidism, antithyroid drugs, radioactive iodine, thyroidectomy, relapse rate, adverse drug reactions, methimazole, propylthiouracil, comparative effectiveness
- MeSH terms
- Female, Graves Disease, Humans, Iodine Radioisotopes, Male, Recurrence, Antithyroid Agents, Thyroidectomy, Databases, Factual, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
