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Cited by 47Thyroid Disorders and TreatmentsThyroid and Parathyroid SurgeryThyroid Cancer Diagnosis and Treatment

Resumption of methimazole after 131I therapy of hyperthyroid diseases: effect on thyroid function and volume evaluated by a randomized clinical trial

Bonnema, SJ, Bennedbaek, FN, Gram, J, Veje, A, Marving, J, Hegedus, L·2003·European Journal of Endocrinology
DOI 10.1530/eje.0.1490485
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Abstract

OBJECTIVE: Retrospective studies have indicated that anti-thyroid drugs (ATD) might possess a radioprotective effect, leading to a higher rate of recurrence of hyperthyroidism after iodine-131 ((131)I) therapy. DESIGN: A randomized clinical trial was performed to clarify whether resumption of methimazole after (131)I influences the final outcome of this treatment. METHODS: We assigned 149 patients with Graves' disease or a toxic nodular goitre to groups either to resume (+ATD) or not to resume (-ATD) methimazole 7 days after (131)I. Before (131)I therapy, all patients were rendered euthyroid by methimazole, which was discontinued 4 days before the (131)I therapy. RESULTS: During the follow-up period of 12 Months, 13 patients developed hypothyroidism, 42 were euthyroid, and 18 had recurrence of hyperthyroidism in the +ATD group; the respective numbers in the -ATD group were 16, 42 and 18 (P=0.88). At 3 weeks after (131)I therapy, the serum free-thyroxine index was slightly decreased (by 5.7%; 95% confidence interval (CI) -15.5 to 5.4%) in the +ATD group, in contrast to an increase of 35.9% (95% CI 18.8 to 55.5%) in the -ATD group (P<0.001 between groups). In the subgroup that remained euthyroid during follow-up, thyroid Volume reduction, assessed by ultrasonography, was smaller in the +ATD group [38.7% (95% CI 33.3 to 44.1%)] than in the -ATD group [48.6% (95% CI: 41.5-55.6%)] (P<0.05). CONCLUSION: No radioprotective effect could be demonstrated, with regard to final thyroid function, for the resumpton of methimazole 7 days after (131)I therapy. Although resumption of methimazole slightly reduced the magnitude of shrinkage of the goitre obtained by (131)I, the prevention of a temporary thyrotoxicosis in the early period after radiation favours this regimen.

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Authors
Bonnema, S., Bennedbaek, F., Gram, J., Veje, A., Marving, J., & Hegedus, L.
Affiliations
Odense University Hospital (DK)
ORCID
Gram, J
Venue
European Journal of Endocrinology
Publisher
Oxford University Press (OUP)
Published
2003-12-01
Volume
149
Issue
6
Pages
485-492
ISSN
  • 0804-4643 (ISSN-L)
  • 1479-683X
DOI
10.1530/eje.0.1490485
OpenAlex
W2103445173
Cited by
47
References
35
Citations by year
2026: 1 · 2025: 1 · 2024: 1 · 2021: 1 · 2020: 2 · 2019: 1 · 2018: 5 · 2017: 1 · 2016: 3 · 2015: 3 · 2014: 2 · 2013: 2 · 2012: 5
FWCI
1.22
Type
journal article
Language
en
Open access
closed
Locations
  • European Journal of Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
  • University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion)
Funders
A.P. Møller og Hustru Chastine Mc-Kinney Møllers Fond til almene Formaal
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
Keywords
methimazole, iodine-131 therapy, hyperthyroidism, Graves' disease, toxic nodular goiter, antithyroid drugs, radioprotective effect, hypothyroidism, hyperthyroidism recurrence, thyroid volume, free thyroxine index, thyroid function, thyroid ultrasound
MeSH terms
Aged, Combined Modality Therapy, Female, Follow-Up Studies, Goiter, Nodular, Graves Disease, Humans, Iodine Radioisotopes, Male, Methimazole, Middle Aged, Radiation-Protective Agents, Recurrence, Antithyroid Agents, Treatment Outcome

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