Graves' hyperthyroidism: single-dose RAI effective for >90% of patients

  • Wong KK & al.
  • Clin Diabetes Endocrinol
  • 1 Jan 2018

  • curated by Brian Richardson, PhD
  • Clinical Essentials
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Takeaway

  • A single calculated dose of radioactive iodine (RAI) is associated with a >90% success rate for treating Graves' hyperthyroidism at a single center.

Why this matters

  • The goals and methods of RAI therapy for Graves' disease vary widely, with little analysis of using a single dose to eliminate hyperthyroidism.

Key results

  • 295 (93.4%) of 316 patients were successfully treated (hypothyroidism within 3-6 months) with a single dose.
    • 18 patients were successfully treated with a second dose,
    • 2 patients were successfully treated with a third dose, and
    • 1 patient underwent thyroidectomy.
  • Failure of RAI therapy was associated with previous propylthiouracil therapy (P=.004).
  • The mean response time after successful RAI ablation was 110.2 days.
    • Cumulative response rates of 25% at 61 days, 50% at 84 days, and 75% at 118 days.

Study design

  • 316 patients with Graves' disease and associated hyperthyroidism, 56.6% with no prior therapy, 1.9% who received thyroid surgery, and 41.5% treated with antithyroid medications, were treated with a calculated RAI dose (0.2 mCi/estimated gram thyroid tissue, adjusted for 24-hour RAI uptake) and analyzed for outcomes.
  • Funding: None.

Limitations

  • Retrospective study.
  • Adverse effects not reported.

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