Evidence map›Paper›PMID 29946800›Full record

Observational studyJournal of endocrinological investigation2018

Antithyroid drug treatment for Graves' disease: baseline predictive models of relapse after treatment for a patient-tailored management.

E Masiello, G Veronesi, D Gallo, P Premoli, E Bianconi, S Rosetti, C Cusini, J Sabatino, S Ippolito, E Piantanida and 4 more

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Journal of endocrinological investigation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
38citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

38 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Safety of long-term antithyroid drug treatment? A systematic review.Journal of endocrinological investigation · 2019
    Pooled it
  4. Pooled it
  5. Trial
  6. Article
  7. Article
  8. Article
  9. Review
  10. Review
  11. Article
  12. Management Aspects of Medical Therapy in Graves Disease.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2025
    Review
  13. A Predictive Model for Graves' Disease Recurrence After Antithyroid Drug Therapy: A Retrospective Multicenter Cohort Study.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2025
    Observational
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Long-term management of Graves disease: a narrative review.Journal of Yeungnam medical science · 2023
    Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

E MasielloDepartment of Medicine and Surgery, Endocrine Unit, ASST dei Sette Laghi, Ospedale di Circolo, University of Insubria, Viale Borri, 57, 21100, Varese, Italy.
G VeronesiResearch Centre in Epidemiology and Preventive Medicine, University of Insubria, Varese, Italy.
D GalloDepartment of Medicine and Surgery, Endocrine Unit, ASST dei Sette Laghi, Ospedale di Circolo, University of Insubria, Viale Borri, 57, 21100, Varese, Italy.
P PremoliDepartment of Medicine and Surgery, Endocrine Unit, ASST dei Sette Laghi, Ospedale di Circolo, University of Insubria, Viale Borri, 57, 21100, Varese, Italy.
E BianconiDepartment of Medicine and Surgery, Endocrine Unit, ASST dei Sette Laghi, Ospedale di Circolo, University of Insubria, Viale Borri, 57, 21100, Varese, Italy.
S RosettiDepartment of Medicine and Surgery, Endocrine Unit, ASST dei Sette Laghi, Ospedale di Circolo, University of Insubria, Viale Borri, 57, 21100, Varese, Italy.
C CusiniDepartment of Medicine and Surgery, Endocrine Unit, ASST dei Sette Laghi, Ospedale di Circolo, University of Insubria, Viale Borri, 57, 21100, Varese, Italy.
J SabatinoDepartment of Medicine and Surgery, Endocrine Unit, ASST dei Sette Laghi, Ospedale di Circolo, University of Insubria, Viale Borri, 57, 21100, Varese, Italy.
S IppolitoDepartment of Medicine and Surgery, Endocrine Unit, ASST dei Sette Laghi, Ospedale di Circolo, University of Insubria, Viale Borri, 57, 21100, Varese, Italy.
E PiantanidaDepartment of Medicine and Surgery, Endocrine Unit, ASST dei Sette Laghi, Ospedale di Circolo, University of Insubria, Viale Borri, 57, 21100, Varese, Italy.
M L TandaDepartment of Medicine and Surgery, Endocrine Unit, ASST dei Sette Laghi, Ospedale di Circolo, University of Insubria, Viale Borri, 57, 21100, Varese, Italy.
L ChiovatoICS Maugeri I.R.C.C.S., University of Pavia, Pavia, Italy.
W M WiersingaAcademic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
L BartalenaDepartment of Medicine and Surgery, Endocrine Unit, ASST dei Sette Laghi, Ospedale di Circolo, University of Insubria, Viale Borri, 57, 21100, Varese, Italy. luigi.bartalena@uninsubria.it.

Funding

Ministry of Education, University and Research (MIUR, Rome) PRIN 2012Z3F7HE-006Ministry of Education, University and Research (MIUR, Rome) PRIN 2015HPMLFY-009
6 · The paper itself

Abstract

backgroundAntithyroid drugs (ATDs) are first-line treatment for Graves' hyperthyroidism worldwide, but relapses are frequent. The reliability of individual risk factors to predict at baseline subsequent relapse is poor. Predictive scores grouping single risk factors might help to select the best treatment (pharmacological vs. ablative).

objectiveTo assess the predictivity of a recently developed score (Clinical Severity Score, CSS) and to compare it with another score (GREAT score). PATIENTS: A retrospective observational, single-center study was conducted of 387 consecutive, newly diagnosed Graves' patients, who completed an 18-24 months ATD course and were followed for at least 2 years.

resultsHyperthyroidism relapsed in 185 patients (48%). At diagnosis and before treatment, the relapse group had higher serum TSH-receptor antibody and free thyroxine levels and larger goiters than the remission group, with no differences in Graves' orbitopathy prevalence and severity. In the multivariate analyses, only large goiter size was significantly associated with an increased recurrence hazard ratio. Using CSS, the risk of relapse increased from 36% in the mild category and 49% in the moderate category to 59% in the severe category, with quite a good area under the curve (AUC) (0.60; 95% CI: 0.55; 0.66). GREAT score showed an increase in relapse from 34% for class I (mild) and 49% for class II (moderate) to 64% for class III (severe) (AUC, 0.63; CI: 0.58; 0.68).

conclusionsBoth CSS and GREAT score are useful, although imperfect, tools to predict at baseline relapse of hyperthyroidism after treatment. In real life they may help the clinician to tailor a treatment for newly diagnosed Graves' hyperthyroidism.

Indexed as

Models, TheoreticalAdultAntithyroid AgentsFemaleGraves DiseaseHumansMaleMiddle AgedRecurrenceRetrospective StudiesSeverity of Illness IndexThyroid Function TestsThyroxineAntithyroid AgentsThyroxineAntithyroid drugsGoiterGraves’ diseaseGraves’ orbitopathyHyperthyroidismPredictive modelsRecurrenceTSH-receptor antibody

Identifiers

PMID29946800

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.