Evidence map›Paper›PMID 34987480›Full record

Trial reportFrontiers in endocrinology2021

The Differential Effects of Propylthiouracil and Methimazole as Graves' Disease Treatment on Vascular Atherosclerosis Markers: A Randomized Clinical Trial.

Wismandari Wisnu, Idrus Alwi, Nafrialdi Nafrialdi, Kuntjoro Harimurti, Tjokorda Gede D Pemayun, Sri Widia A Jusman, Dewi Irawati S Santoso, Alida R Harahap, Suhendro Suwarto, Imam Subekti

Open access · goldAbstract readComparative StudyRandomized Controlled Trial
In one paragraph

Trial report in Frontiers in endocrinology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.0field-weighted citation impact, top 22% 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

4 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Review
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

10 authors at 4 institutions in 1 country.

Wismandari WisnuDivision of Endocrine, Metabolism and Diabetes, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
Idrus AlwiDivision of Cardiology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
Nafrialdi NafrialdiDepartment of Pharmacology and Therapeutics, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Kuntjoro HarimurtiDivision of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
Tjokorda Gede D PemayunDivision of Endocrine, Metabolism, and Diabetes, Department of Internal Medicine, Faculty of Medicine, Diponegoro University, Dr. Kariadi General Hospital, Semarang, Indonesia.
Sri Widia A JusmanDepartment of Biochemistry and Molecular Biology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Dewi Irawati S SantosoDepartment of Medical Physiology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Alida R HarahapEijkman Institute for Molecular Biology, Jakarta, Indonesia.
Suhendro SuwartoDivision of Tropical and Infectious Disease, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
Imam SubektiDivision of Endocrine, Metabolism and Diabetes, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
University of Indonesia · IDRumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo · IDDr. Kariadi Hospital · IDEijkman Institute for Molecular Biology · ID

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Hyperthyroidism is related to vascular atherosclerosis. Propylthiouracil (PTU) and methimazole, other than their antithyroid effects, may have different mechanisms in preventing atherogenesis in Graves' disease. Objective: This study aimed to investigate the effect of antithyroid drugs on markers of vascular atherosclerosis in Graves' hyperthyroidism. Methods: This study was a single-blind, randomized clinical trial conducted on 36 patients with Graves' disease in Cipto Mangunkusumo General Hospital, Jakarta, Indonesia, from June 2019 until July 2020. Graves' disease was diagnosed from clinical manifestation of hyperthyroidism with diffuse goiter and then confirmed by thyroid stimulation hormone (TSH), free T4 (fT4), and TSH-receptor antibody (TRAb) measurements. Participants were randomly assigned to either a PTU or a methimazole treatment group and followed up for 3 months. Markers of vascular atherosclerosis were represented by adhesion molecules [intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and E-selectin], carotid artery stiffness [pulse wave velocity (PWV)], and thickness [carotid intima media thickness (cIMT)]. Results: By the end of the study, 24 participants reached euthyroid condition (13 from the PTU group and 11 from the methimazole group). After 3 months of follow-up, in the PTU group, we noticed an improvement of ICAM-1 [pretreatment: 204.1 (61.3) vs. posttreatment: 141.6 (58.4) ng/ml; p = 0.001], VCAM-1 [837 (707-977) vs. 510 (402-630) ng/ml; p < 0.001] and E-selectin [32.1 (24.1-42.7) vs. 28.2 (21.6-36.8) ng/ml; p = 0.045] in the PTU group. In the methimazole group, only VCAM-1 improvement [725 (565-904) vs. 472 (367-590); p = 0.001] was observed. Meanwhile, we found no significant changes in PWV or cIMT in either group. Conclusion: Antithyroid treatment in Graves' disease leads to improvement in adhesion molecules, with a lesser effect on methimazole, whereas there were no significant changes in PWV or cIMT. PTU may have a better mechanism compared with methimazole in terms of improving adhesion molecules.

Indexed as

AdultAntithyroid AgentsAtherosclerosisBiomarkersFemaleFollow-Up StudiesGraves DiseaseHumansIntercellular Adhesion Molecule-1MaleMethimazoleMiddle AgedPropylthiouracilPulse Wave AnalysisSingle-Blind MethodThyroid HormonesAntithyroid AgentsBiomarkersICAM1 protein, humanIntercellular Adhesion Molecule-1MethimazolePropylthiouracilThyroid HormonesVascular Cell Adhesion Molecule-1adhesion moleculescarotid intima media thicknessGraves’ diseasehyperthyroidismmethimazolepropylthiouracilpulse wave velocityvascular atherosclerosis

Identifiers

PMID34987480
PMCPMC8721229
OpenAlexW4200253401

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

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.