Faculty of Medicine, Division of Endocrinology and Metabolism, Department of Internal Medicine, Dr. Cipto Mangunkusumo General Hospital, Universitas Indonesia, Jakarta, Indonesia.
Faculty of Medicine, Department of Internal Medicine, Dr. Cipto Mangunkusumo General Hospital, Universitas Indonesia, Jakarta, Indonesia.
PLoS One. 2021 Jan 29;16(1):e0245978. doi: 10.1371/journal.pone.0245978. eCollection 2021.
Graves' disease (GD) has a high recurrence rate despite various and adequate treatment. Numerous studies have been performed to identify the predictor of disease recurrence. This report aims to investigate the role of thyroid stimulating hormone (TSH) level as a thyrotropin in predicting the recurrence of Graves' disease within 1 to 2 years following antithyroid drug (ATD) withdrawal. Literature searching was conducted on PubMed, Scopus, Cochrane, Proquest, EBSCO in August 2019 and Google Scholar in October 2020. The study criteria include the study that evaluates TSH level 4 weeks following ATD withdrawal, with subjects ≥18 years old who are retrospectively or prospectively followed up after 1 to 2 years following ATD withdrawal. Four eligible studies were selected based on inclusion/exclusion criteria, all of which measured TSH level at 4 weeks following ATD withdrawal. All studies had 1 to 2 years follow up. One study was an RCT, two studies were done in prospective cohort and another in retrospective cohort. All studies had comparable validity and applicability. Three out of four studies suggested that low TSH level measured 4 weeks following treatment withdrawal was associated with higher risk of disease recurrence. In conclusion, low TSH level obtained 4 weeks after ATD withdrawal was associated with higher rate of recurrence rate in GD.
格雷夫斯病（GD）尽管经过各种适当的治疗，但仍有很高的复发率。已经进行了许多研究以确定疾病复发的预测因素。本报告旨在探讨促甲状腺激素（TSH）水平作为促甲状腺激素在预测抗甲状腺药物（ATD）停药后 1 至 2 年内格雷夫斯病复发中的作用。2019 年 8 月在 PubMed、Scopus、Cochrane、Proquest、EBSCO 上以及 2020 年 10 月在 Google Scholar 上进行了文献检索。研究标准包括评估 ATD 停药后 4 周 TSH 水平的研究，研究对象为年龄≥18 岁的患者，在 ATD 停药后 1 至 2 年内进行回顾性或前瞻性随访。根据纳入/排除标准，选择了 4 项符合条件的研究，所有研究均在 ATD 停药后 4 周测量了 TSH 水平。所有研究的随访时间均为 1 至 2 年。其中一项为 RCT，两项为前瞻性队列研究，另一项为回顾性队列研究。所有研究均具有可比性的有效性和适用性。四项研究中有三项表明，治疗停药后 4 周测量的低 TSH 水平与疾病复发的风险增加有关。总之，ATD 停药后 4 周时 TSH 水平降低与 GD 复发率升高有关。
