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
Bahn, R. S., Burch, H. B., Cooper, D. S., Garber, J. R., Greenlee, M. C., Klein, I., Laurberg, P., McDougall, I. R., Montori, V. M., Rivkees, S. A., et al. (2011) · Endocrine Practice · doi:10.4158/ep.17.3.456 · Cited by 1,098
Self-citationRelation between Therapy for Hyperthyroidism and the Course of Graves' Ophthalmopathy
Bartalena, L., Marcocci, C., Bogazzi, F., Manetti, L., Tanda, M. L., Dell'Unto, E., Bruno-Bossio, G., Nardi, M., Bartolomei, M. P., Lepri, A., et al. (1998) · New England Journal of Medicine · doi:10.1056/nejm199801083380201 · Cited by 715
Brent, G. A. (2008) · New England Journal of Medicine · doi:10.1056/nejmcp0801880 · Cited by 592
Occurrence of Ophthalmopathy after Treatment for Graves' Hyperthyroidism
Tallstedt, L., Lundell, G., Tørring, O., Wallin, G., Ljunggren, J.-G., Blomgren, H., & Taube, A. (1992) · New England Journal of Medicine · doi:10.1056/nejm199206253262603 · Cited by 521
Current Perspective on the Pathogenesis of Graves’ Disease and Ophthalmopathy
Prabhakar, B. S., Bahn, R. S., & Smith, T. J. (2003) · Endocrine Reviews · doi:10.1210/er.2002-0020 · Cited by 493
Self-citationHow to Use an Article Reporting a Multiple Treatment Comparison Meta-analysis
Mills, E. J., Ioannidis, J. P. A., Thorlund, K., Schünemann, H. J., Puhan, M. A., & Guyatt, G. H. (2012) · JAMA · doi:10.1001/2012.jama.11228 · Cited by 365
A 2011 Survey of Clinical Practice Patterns in the Management of Graves' Disease
Burch, H. B., Burman, K. D., & Cooper, D. S. (2012) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2012-2802 · Cited by 346
Törring, O., Tallstedt, L., Wallin, G., Lundell, G. E. F., Ljunggren, J. ‐., Taube, A., Sääf, M., & Hamberger, B. (1996) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.81.8.8768863 · Cited by 311
Radioiodine Therapy for Hyperthyroidism
Ross, D. S. (2011) · New England Journal of Medicine · doi:10.1056/nejmct1007101 · Cited by 286
Thyrotropin receptor-associated diseases: from adenomata to Graves disease
Davies, T. F. (2005) · Journal of Clinical Investigation · doi:10.1172/jci26031 · Cited by 260
Abraham-Nordling, M., Törring, O., Hamberger, B., Lundell, G., Tallstedt, L., Calissendorff, J., & Wallin, G. (2005) · Thyroid · doi:10.1089/thy.2005.15.1279 · Cited by 163
A Survey Study of Neuropsychiatric Complaints in Patients With Graves' Disease
(1996) · The Journal of Neuropsychiatry and Clinical Neurosciences · doi:10.1176/jnp.8.2.181 · Cited by 113
Genovese, B. M., Noureldine, S. I., Gleeson, E., Tufano, R. P., & Kandil, E. H. (2012) · Annals of Surgical Oncology · doi:10.1245/s10434-012-2606-x · Cited by 97
Guo, Z., Yu, P., Liu, Z., Si, Y., & Jin, M. (2013) · Clinical Endocrinology · doi:10.1111/cen.12209 · Cited by 68
SUGRUE, D. D., McEvoy, M., Feely, J., & Drury, M. I. (1980) · QJM · doi:10.1093/oxfordjournals.qjmed.a067604 · Cited by 67
Berglund, J., Christensen, S. B., Dymling, J. ‐., & Hallengren, B. (1991) · Journal of Internal Medicine · doi:10.1111/j.1365-2796.1991.tb00371.x · Cited by 57
Long-term outcomes of treatment of hyperthyroidism in Ireland
Leary, A. C., Grealy, G., Higgins, T. M., Buckley, N. A., Barry, D. G., Murphy, D. B., & Ferriss, J. B. (1999) · Irish Journal of Medical Science (1971 -) · doi:10.1007/bf02939582 · Cited by 14
Tütüncü, N. B., Tütüncü, T., Özgen, A., & Erbas, T. A. (2006) · PubMed Central · Cited by 8
A prospective study of 110 Ethiopians with thyrotoxicosis.
Mengistu, M. (1992) · PubMed · Cited by 7
[Treatment of Basedow-Graves' hyperthyroidism: retrospective analysis after 30 years].
Pineda, G., V, Arancibia, P. T., & Mejía, G. (1998) · PubMed · Cited by 4
Comparative follow-up of patients with hyperthyroidism treated with 131 or surgery.
Alizadeh, J., & Ward, J. A. (1979) · PubMed · Cited by 1
Cited by
Sorted by citations
Ross, D. S., Burch, H. B., Cooper, D. S., Greenlee, M. C., Laurberg, P., Maia, A. L., Rivkees, S. A., Samuels, M., Sosa, J. A., Stan, M. N., et al. (2016) · Thyroid® · doi:10.1089/thy.2016.0229 · Cited by 2,938
“In a recent systematic review of eight studies that included 667 GD patients receiving MMI or PTU, 13% of patients experienced adverse events (122).”
BackgroundSelf-citation2018 European Thyroid Association Guideline for the Management of Graves’ Hyperthyroidism
Kahaly, G. J., Bartalena, L., Hegedüs, L., Leenhardt, L., Poppe, K. G., & Pearce, S. H. S. (2018) · European Thyroid Journal · doi:10.1159/000490384 · Cited by 1,025
Patel, K. N., Yip, L., Lubitz, C. C., Grubbs, E. G., Miller, B. S., Shen, W. T., Angelos, P., Chen, H., Doherty, G. M., Fahey, T. J., et al. (2020) · Annals of Surgery · doi:10.1097/sla.0000000000003580 · Cited by 567
Burch, H. B., & Cooper, D. S. (2015) · JAMA · doi:10.1001/jama.2015.16535 · Cited by 344
Lee, S. Y., & Pearce, E. N. (2023) · JAMA · doi:10.1001/jama.2023.19052 · Cited by 364
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
