PMID- 19850691
OWN - NLM
STAT- MEDLINE
DCOM- 20100105
LR  - 20141120
IS  - 1945-7197 (Electronic)
IS  - 0021-972X (Linking)
VI  - 94
IP  - 12
DP  - 2009 Dec
TI  - Prevention of relapse of Graves' disease by treatment with an intrathyroid 
      injection of dexamethasone.
PG  - 4984-91
LID - 10.1210/jc.2009-1252 [doi]
AB  - INTRODUCTION: Antithyroid drugs are widely used in the treatment of Graves' 
      disease (GD), but the relapse rate is very high after therapy withdrawal. We 
      evaluated the reduction effects of intrathyroid injection of dexamethasone (IID) 
      on the relapse rate of hyperthyroidism in patients with newly diagnosed GD. 
      PATIENTS AND METHODS: A total of 191 patients with GD completed the study. After 
      6 months of treatment with methimazole (MMI), the patients were randomly assigned 
      to receive either MMI (96 patients) alone or MMI combined with IID (MMI+IID; 95 
      patients) treatment for 3 months, followed by continuing a dose of MMI that would 
      maintain euthyroidism for the next 9 months in all of the patients. After 
      withdrawal of the medical therapy, patients were followed for 24 months, and the 
      relapse rate of hyperthyroidism was evaluated. RESULTS: No statistical difference 
      was observed in the levels of serum FT(4), TSH, or TSH receptor antibodies 
      (TR-Ab), the thyroid volume, or the TR-Ab positive rate between the two groups at 
      month 6. After the next 3 months of treatment with MMI+IID or MMI alone, the 
      levels of TSH increased significantly, and the levels of serum TR-Ab, the TR-Ab 
      positive rate, and thyroid volume decreased significantly in the MMI+IID group 
      compared with the MMI group. Seven patients (7.4%) experienced a relapse of overt 
      hyperthyroidism in the MMI+IID group and 49 patients (51%) in MMI group during 
      the 2-yr follow-up period (P < 0.001). CONCLUSIONS: MMI+IID treatment is helpful 
      to prevent relapse of hyperthyroidism in GD after medical therapy withdrawal.
FAU - Mao, Xiao-Ming
AU  - Mao XM
AD  - Department of Endocrinology, Affiliated Nanjing First Hospital, Nanjing Medical 
      University, 68 ChangLe Street, Nanjing 210006, China. maoxming@163.com
FAU - Li, Hui-Qin
AU  - Li HQ
FAU - Li, Qian
AU  - Li Q
FAU - Li, Dong-Mei
AU  - Li DM
FAU - Xie, Xiao-Jing
AU  - Xie XJ
FAU - Yin, Guo-Ping
AU  - Yin GP
FAU - Zhang, Peng
AU  - Zhang P
FAU - Xu, Xiang-Hong
AU  - Xu XH
FAU - Wu, Jin-Dan
AU  - Wu JD
FAU - Chen, Song-Wang
AU  - Chen SW
FAU - Wang, Shu-Kui
AU  - Wang SK
LA  - eng
SI  - ClinicalTrials.gov/NCT00917241
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20091022
PL  - United States
TA  - J Clin Endocrinol Metab
JT  - The Journal of clinical endocrinology and metabolism
JID - 0375362
RN  - 0 (Anti-Inflammatory Agents)
RN  - 0 (Antithyroid Agents)
RN  - 0 (Thyroid Hormones)
RN  - 554Z48XN5E (Methimazole)
RN  - 7S5I7G3JQL (Dexamethasone)
RN  - 9002-71-5 (Thyrotropin)
SB  - IM
MH  - Adult
MH  - Anti-Inflammatory Agents/administration & dosage/adverse effects/*therapeutic use
MH  - Antithyroid Agents/adverse effects/therapeutic use
MH  - Dexamethasone/administration & dosage/adverse effects/*therapeutic use
MH  - Drug Therapy, Combination
MH  - Female
MH  - Follow-Up Studies
MH  - Goiter/pathology
MH  - Graves Disease/pathology/*prevention & control
MH  - Humans
MH  - Injections
MH  - Male
MH  - Methimazole/adverse effects/therapeutic use
MH  - Middle Aged
MH  - Secondary Prevention
MH  - Thyroid Gland/pathology/*physiology
MH  - Thyroid Hormones/blood
MH  - Thyrotropin/blood
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2009/10/24 06:00
MHDA- 2010/01/06 06:00
CRDT- 2009/10/24 06:00
PHST- 2009/10/24 06:00 [entrez]
PHST- 2009/10/24 06:00 [pubmed]
PHST- 2010/01/06 06:00 [medline]
AID - jc.2009-1252 [pii]
AID - 10.1210/jc.2009-1252 [doi]
PST - ppublish
SO  - J Clin Endocrinol Metab. 2009 Dec;94(12):4984-91. doi: 10.1210/jc.2009-1252. Epub 
      2009 Oct 22.