Evidence map›Paper›PMID 32524368›Full record

Observational studyJournal of endocrinological investigation2021

Antithyroid drugs in Graves' hyperthyroidism: differences between "block and replace" and "titration" regimes in frequency of euthyroidism and Graves' orbitopathy during treatment.

M Žarković, W Wiersinga, P Perros, L Bartalena, S Donati, O Okosieme, D Morris, N Fichter, J Lareida, C Daumerie and 14 more

Open access · greenAbstract readMulticenter StudyObservational Study
PubMed Publisher
In one paragraph

Observational study in Journal of endocrinological investigation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 18% of its field
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

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Observational
  6. Article
  7. 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

24 authors at 13 institutions in 9 countries.

M Žarković *School of Medicine, University of Belgrade, Belgrade, Serbia. milos.zarkovic@med.bg.ac.rs.ORCID http://orcid.org/0000-0001-9977-5970
W Wiersinga *Department of Endocrinology and Metabolism, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands.
P PerrosDepartment of Endocrinology, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
L BartalenaSchool of Medicine, University of Insubria, Varese, Italy.
S DonatiSchool of Medicine, University of Insubria, Varese, Italy.
O OkosiemeDepartment of Endocrinology, Institute of Molecular and Experimental Medicine, Cardiff University School of Medicine, Cardiff, UK.
D MorrisCardiff Eye Unit, University Hospital of Wales, Cardiff, UK.
N FichterInterdisciplinary Centre for Graves' Orbitopathy, Olten and University Eye Hospital, Basel, Switzerland.
J LareidaInterdisciplinary Centre for Graves' Orbitopathy, Olten and University Eye Hospital, Basel, Switzerland.
C DaumerieDepartment of Endocrinology, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
M-C BurlacuDepartment of Endocrinology, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
G J KahalyDepartment of Medicine I, Johannes Gutenberg University Medical Center, Mainz, Germany.
S PitzOrbital Center, Ophthalmic Clinic, Buergerhospital, Frankfurt, Germany.
B BeleslinSchool of Medicine, University of Belgrade, Belgrade, Serbia.
J ĆirićSchool of Medicine, University of Belgrade, Belgrade, Serbia.
G AyvazDepartment of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Ankara, Turkey.
O KonukDepartment of Ophthalmology, Faculty of Medicine, Gazi University, Ankara, Turkey.
F B TörünerDepartment of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Ankara, Turkey.
M SalviGraves' Orbitopathy Unit, Department of Clinical Science and Community Health, Fondazione Ca'Granda IRCCS, University of Milan, Milan, Italy.
D CovelliGraves' Orbitopathy Unit, Department of Clinical Science and Community Health, Fondazione Ca'Granda IRCCS, University of Milan, Milan, Italy.
N CurroDepartment of Ophthalmology, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy.
L HegedüsDepartment of Endocrinology and Metabolism, Odense University Hospital, University of Southern Denmark, Odense, Denmark.
T BrixDepartment of Endocrinology and Metabolism, Odense University Hospital, University of Southern Denmark, Odense, Denmark.
EUGOGO (European Group on Graves’ Orbitopathy)
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico · ITGazi University · TRUniversity of Belgrade · RSCliniques Universitaires Saint-Luc · BEUniversity Hospital of Basel · CHUniversity of Insubria · ITUniversity of Southern Denmark · DKAmsterdam UMC Location University of Amsterdam · NLBürgerhospital Frankfurt am Main · DECardiff University · GBJohannes Gutenberg University Mainz · DERoyal Victoria Infirmary · GBUniversity Hospital of Wales · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWhereas antithyroid drugs (ATD) are the preferred treatment modality for Graves' hyperthyroidism (GH), there is still controversy about the optimal regimen for delivering ATD. To evaluate whether 'Block and Replace' (B + R) and 'Titration' (T) regimes are equivalent in terms of frequency of euthyroidism and Graves' Orbitopathy (GO) during ATD therapy.

methodsA prospective multicentre observational cohort study of 344 patients with GH but no GO at baseline. Patients were treated with ATD for 18 months according to B + R or T regimen in line with their institution's policy.

resultsBaseline characteristics were similar in both groups. In the treatment period between 6 and 18 months thyrotropin (TSH) slightly increased in both groups, but TSH was on average 0.59 mU/L (95% CI 0.27-0.85) lower in the B + R group at all time points (p = 0.026). Serum free thyroxine (FT4) remained stable during the same interval, with a tendency to higher values in the B + R group. The point-prevalence of euthyroidism (TSH and FT4 within their reference ranges) increased with longer duration of ATD in both groups; it was always higher in the T group than in the B + R group: 48 and 24%, respectively, at 6 months, 81 and 58% at 12 months, and 87 and 63% at 18 months (p < 0.002). There were no significant differences between the B + R and T regimens with respect to the fall in thyrotropin binding inhibiting immunoglobulins (TBII) or thyroid peroxidase antibodies (TPO-Ab). GO developed in 15.9% of all patients: 9.1 and 17.8% in B + R group and T group, respectively, (p = 0.096). GO was mild in 13% and moderate-to-severe in 2%.

conclusionThe prevalence of biochemical euthyroidism during treatment with antithyroid drugs is higher during T compared to B + R regimen. De novo development of GO did not differ significantly between the two regimens, although it tended to be higher in the T group. Whether one regimen is clinically more advantageous than the other remains unclear.

Indexed as

AdultAntithyroid AgentsEuropeFemaleFollow-Up StudiesGraves DiseaseGraves OphthalmopathyHumansHyperthyroidismMalePrognosisProspective StudiesThyroid Function TestsThyroid HormonesTime FactorsAntithyroid AgentsThyroid HormonesAntithyroid drugsGraves’ disease treatmentGraves’ orbitopathyHyperthyroidism

Identifiers

PMID32524368
OpenAlexW3033610368

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.