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Thiamazole as an adjuvant to radioiodine for the treatment of multinodular goiter

Albino, C.C; Graf, Hans; Sampaio, AP; Vigario, A; Da Paz Filho, Gilberto

Description

Background: Radioiodine (131I) is an alternative to surgery for the treatment of multinodular goiter (MNG). Frequently, high activities of 131I are required for effective thyroid volume reduction (TV), due to the low and heterogeneous radioactive iodine uptake (RAIU). Thiamazole (MTZ) may be used as an adjuvant to 131I, by increasing (RAIU). Objective: To evaluate the effects of MTZ in the treatment of MNG with 131I, in terms of TV reduction. Design/methods: Nine female patients (aged 73.8 ±...[Show more]

dc.contributor.authorAlbino, C.C
dc.contributor.authorGraf, Hans
dc.contributor.authorSampaio, AP
dc.contributor.authorVigario, A
dc.contributor.authorDa Paz Filho, Gilberto
dc.date.accessioned2015-12-08T22:18:01Z
dc.identifier.issn1354-3784
dc.identifier.urihttp://hdl.handle.net/1885/31159
dc.description.abstractBackground: Radioiodine (131I) is an alternative to surgery for the treatment of multinodular goiter (MNG). Frequently, high activities of 131I are required for effective thyroid volume reduction (TV), due to the low and heterogeneous radioactive iodine uptake (RAIU). Thiamazole (MTZ) may be used as an adjuvant to 131I, by increasing (RAIU). Objective: To evaluate the effects of MTZ in the treatment of MNG with 131I, in terms of TV reduction. Design/methods: Nine female patients (aged 73.8 ± 7.4 years) with MNG (eight with subclinical hyperthyroidism) were treated with MTZ. Doses started at 10 - 20 mg, and were adjusted monthly based on thyroid hormone levels. RAIU and TV were measured at baseline, and repeated when TSH levels > 6 mU/l were achieved. At that time, 1.11 GBq of 131I were administered. Results: Patients were treated with MTZ for 2.8 ± 0.8 months. When a tracer activity of 131I was administered, the mean serum TSH was elevated to 11.7 ± 5.4 mU/l. MTZ led to significant increases in 24-h RAIU, from 21.3 ± 8.1% to 78.3 ± 15.3% (p < 0.001). One year after 131I, median TV decreased from 97 ml (range 47 - 555 ml) to 56 ml (range 13 - 350 ml), a mean reduction of 46.2 ± 17.8% (p = 0.012). Eight patients (89%) had subclinical hyperthyroidism, which was reversed in all patients after 1 year. Five patients (56%) developed overt hypothyroidism, and no clinical adverse events were observed. Conclusion: Pretreatment with MTZ targeting against an increased serum TSH did not impair the effects of 131I. In our patients with MNG, MTZ increased RAIU and possibly enhanced 131I efficacy, leading to significant TV reduction and reversion of hyperthyroidism in all patients.
dc.publisherInforma Healthcare
dc.sourceExpert Opinion on Investigational Drugs
dc.subjectKeywords: iodine 131; levothyroxine; thiamazole; thyroid hormone; radioactive iodine; add on therapy; aged; article; clinical article; drug effect; drug efficacy; drug potentiation; drug uptake; female; goiter; human; hyperthyroidism; hypothyroidism; nodular goiter 131I; Goiter; Radioiodine; Thiamazole; Thyroid; Uptake
dc.titleThiamazole as an adjuvant to radioiodine for the treatment of multinodular goiter
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume17
dc.date.issued2008
local.identifier.absfor110306 - Endocrinology
local.identifier.ariespublicationu4693331xPUB80
local.type.statusPublished Version
local.contributor.affiliationAlbino, C.C, Instituto de Diabetes e Endocrinologia de Maringa
local.contributor.affiliationGraf, Hans, Federal University of Parana
local.contributor.affiliationSampaio, AP, Nucleo Diagnost Maringa
local.contributor.affiliationVigario, A, Nucleo Diagnost Maringa
local.contributor.affiliationDa Paz Filho, Gilberto, College of Medicine, Biology and Environment, ANU
local.description.embargo2037-12-31
local.bibliographicCitation.issue12
local.bibliographicCitation.startpage1781
local.bibliographicCitation.lastpage1786
local.identifier.doi10.1517/13543780802501325
local.identifier.absseo920106 - Endocrine Organs and Diseases (excl. Diabetes)
local.identifier.absseo970111 - Expanding Knowledge in the Medical and Health Sciences
dc.date.updated2016-02-24T11:18:12Z
local.identifier.scopusID2-s2.0-58149385839
local.identifier.thomsonID000261399700002
CollectionsANU Research Publications

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