Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Division of Endocrinology, Department of Medicine, Korea University Ansan Hospital, Ansan, Korea.
Endocrine. 2021 Oct;74(1):120-127. doi: 10.1007/s12020-021-02725-x. Epub 2021 Apr 15.
Current literature suggests 12-18 months of antithyroid drug (ATD) treatment for patients with Graves' disease, but the risk of relapse is high. Although some studies reported better outcomes of long-term ATD treatment, recent data that suggest the optimal treatment duration are limited.
We performed a multicenter retrospective cohort study of 908 patients newly diagnosed with Graves' disease between 2006 and 2013. The relapse rate according to ATD treatment duration was analyzed.
After initial ATD treatment, 338 patients (37.2%) had relapsed. The relapse rate according to ATD treatment duration was 42.4% at 1 year, 38.5% at 2 years, 33.8% at 3 years, 31.7% at 4 years, 30.2% at 5 years, 27.8% at 6 years, and 19.1% at more than 6 years, respectively, demonstrating a significant decreasing trend (p = 0.003). In a multivariable Cox regression analysis, ATD treatment duration was an independent risk factor for relapse (p = 0.043).
The longer that ATD therapy is used, the lower the relapse rate is in patients with Graves' disease. Long-term ATD treatment may be considered in Graves' patients who do not show complications or an economic burden from hyperthyroidism.
目前的文献表明 Graves 病患者需要接受 12-18 个月的抗甲状腺药物（ATD）治疗，但复发风险很高。虽然一些研究报告了长期 ATD 治疗的更好结果，但目前关于最佳治疗持续时间的数据有限。
我们对 2006 年至 2013 年间新诊断为 Graves 病的 908 例患者进行了一项多中心回顾性队列研究。根据 ATD 治疗持续时间分析复发率。
在初始 ATD 治疗后，有 338 例（37.2%）患者复发。根据 ATD 治疗持续时间的复发率分别为：1 年时为 42.4%，2 年时为 38.5%，3 年时为 33.8%，4 年时为 31.7%，5 年时为 30.2%，6 年时为 27.8%，6 年以上时为 19.1%，呈显著下降趋势（p=0.003）。多变量 Cox 回归分析显示，ATD 治疗持续时间是 Graves 病患者复发的独立危险因素（p=0.043）。
ATD 治疗时间越长，Graves 病患者的复发率越低。对于没有出现甲亢并发症或经济负担的 Graves 病患者，可以考虑长期 ATD 治疗。
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