An Assessment of the Occurrence of Hypothyroidism in Patients Treated With RAI for Hyperthyroidism.
Study Details
Study Description
Brief Summary
Low RAIU in patients with hyperthyroidism represents a common obstacle in the treatment with RAI. Therefore, a higher dose of RAI must be administered to cure hyperthyroidism in these patients. If we treat patients with thiamazole before starting RAI treatment, serum TSH will rise and result in an increase in iodine uptake by the thyroid gland. By doing so, the dose of RAI to be administered might be lowered to achieve similar therapeutic efficacy.
In the past, either calculated or fixed doses of 131I have been used to treat hyperthyroidism. The supposed advantage of a calculated dose compared to a fixed dose is the lowering of hypothyroidism frequency. However, various research papers have contradicted this statement.
Antithyroid drugs and RAI therapy have been widely used in the past, either in combination, or independent from one another. This has been done primarily in older patients, to reduce the risk of exacerbation of hyperthyroid symptoms after initiation of RAI.
The use of propylthiouracil has been shown to decrease the response rate after RAI due to radioprotective effects.
The use of methimazole and carbimazole did not have a negative effect on treatment failure, as long as the medication was discontinued various days before RAI administration. Although this statement is contested in other studies.
It is interesting to evaluate retrospective data of patients treated with RAI to evaluate prognostic factors of treatment respons and post RAI hypothyroidism.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Toxic Nodule Hyperthyroid patients with underlying toxic nodule |
Radiation: radioacive iodine therapy
Hyperthyroid patients who have undergone radioactive iodine treatment to cure them from their hyperthyroidism.
|
| Toxic multinodular goiter Hyperthyroid patients with underlying toxic multinodular goiter |
Radiation: radioacive iodine therapy
Hyperthyroid patients who have undergone radioactive iodine treatment to cure them from their hyperthyroidism.
|
Outcome Measures
Primary Outcome Measures
- The proportion of patients in which hypothyroidism occurs [Within 1 year after treatment]
The proportion of patients in which hypothyroidism occurs after radioiodine treatment
- The proportion of patients in which hypothyroidism occurs [Between 1-2 years after treatment]
The proportion of patients in which hypothyroidism occurs after radioiodine treatment
- The proportion of patients in which hypothyroidism occurs [Between 2-5 years after treatment]
The proportion of patients in which hypothyroidism occurs after radioiodine treatment
Eligibility Criteria
Criteria
Inclusion Criteria:
- Hyperthyroid patients, either subclinical or overt, who have undergone RAI treatment in the period of 2005-2015.
Exclusion Criteria:
-
Prior use of L-thyroxine
-
Prior thyroid surgery
-
Prior RAI treatment
-
Patients with thyroiditis
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Universitair Ziekenhuis Brussel | Brussels | Belgium | 1090 |
Sponsors and Collaborators
- Universitair Ziekenhuis Brussel
Investigators
- Principal Investigator: Corina Andreescu, Doctorate, Universitair Ziekenhuis Brussel
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 2019/435