Division of Endocrinology and Metabolism, Johns Hopkins University School of Medicine, 1830 East Monument Street, Baltimore, Maryland 21287, USA.
J Clin Endocrinol Metab. 2010 May;95(5):2227-33. doi: 10.1210/jc.2009-2752. Epub 2010 Mar 24.
The thionamide antithyroid drugs methimazole and propylthiouracil are the mainstay of pharmacologic therapy for Graves' disease. However, little is known about the rate of use of these drugs and the prescribing practices of physicians treating hyperthyroidism.
The objective of the study was to examine the frequency of methimazole and propylthiouracil use from years 1991 to 2008.
The data were acquired by the U.S. Food and Drug Administration's Division of Epidemiology through two databases: IMS National Sales Perspectives and the Surveillance Data, Inc. Vector One: National database.
There was a 9-fold increase in the annual number of methimazole prescriptions during the study period, from 158,000 to 1.36 million per year. There was a 19% increase in the annual number of propylthiouracil prescriptions, from 348,000 to 415,000 per year. Propylthiouracil, which held two thirds of the market from 1991 to 1995, was surpassed by methimazole in 1996. Patient demographic data indicated that although 72% of methimazole prescriptions were for females, males were more likely to be on methimazole (82%) than females (74%) (P < 0.001, two tailed chi(2) test). The only demographic group in which methimazole use decreased was women of child-bearing age (5% decrease, P < 0.001, two tailed chi(2)). The incidence of hyperthyroidism in 2008 was estimated based on the number of new prescriptions of thionamides by age group and data from the 2008 U.S. census: 0.44 per 1000 for ages 0-11 yr, 0.26 per 1000 for ages 12-17 yr, 0.59 per 1000 for ages 18-44 yr, 0.78 per 1000 for ages 45-64 yr, and 1.01 per 1000 for ages 65+ yr.
Methimazole has become the most frequently prescribed antithyroid drug. The remarkable increase in the total number of dispensed thionamide prescriptions over the last 18 yr may indicate a trend toward pharmacological treatment as primary treatment of Graves' disease in the United States.
硫脲类抗甲状腺药物甲巯咪唑和丙基硫氧嘧啶是治疗格雷夫斯病的主要药物。然而，关于这些药物的使用频率和治疗甲状腺功能亢进症的医生的处方实践知之甚少。
本研究旨在考察 1991 年至 2008 年甲巯咪唑和丙基硫氧嘧啶的使用频率。
美国食品和药物管理局流行病学司通过两个数据库获取数据：IMS 国家销售透视和监测数据公司 Vector One：国家数据库。
研究期间，甲巯咪唑的年处方数增加了 9 倍，从每年 158000 增至 1360000 张。丙基硫氧嘧啶的年处方数增加了 19%，从每年 348000 增至 415000 张。丙基硫氧嘧啶在 1991 年至 1995 年占据了三分之二的市场份额，但在 1996 年被甲巯咪唑超越。患者人口统计学数据表明，尽管 72%的甲巯咪唑处方开给女性，但男性使用甲巯咪唑（82%）的可能性高于女性（74%）（P < 0.001，双侧卡方检验）。唯一使用甲巯咪唑减少的人群是生育年龄的妇女（减少 5%，P < 0.001，双侧卡方检验）。根据年龄组的硫脲类新药处方数和 2008 年美国人口普查数据，估计 2008 年甲状腺功能亢进症的发病率为：0-11 岁年龄组为 0.44/1000，12-17 岁年龄组为 0.26/1000，18-44 岁年龄组为 0.59/1000，45-64 岁年龄组为 0.78/1000，65 岁及以上年龄组为 1.01/1000。
甲巯咪唑已成为最常开的抗甲状腺药物。过去 18 年中，硫脲类药物的总处方数显著增加，这可能表明在美国，格雷夫斯病的药物治疗已成为主要治疗方法。
