Predictors of Remission in Graves’ Disease Patients Treated With Antithyroid Drugs: A Retrospective Study

TL;DR

This study identifies factors like male gender, lower BMI, and higher TSH levels that predict remission in Graves' disease patients treated with antithyroid drugs.

Contribution

The study identifies novel predictors of remission in Graves' disease patients treated with antithyroid drugs.

Findings

Male gender was strongly associated with remission (94.4% remission rate in males vs. 50% in females).

Patients who achieved remission had a lower BMI (26.4) compared to those who did not (30.4).

Higher maximum TSH levels during treatment were linked to remission (median 6.5 vs. 1.2).

Abstract

Background and objectives: Graves' disease (GD) is an autoimmune disorder characterized by excessive stimulation of the thyroid gland, resulting in hyperthyroidism. Antithyroid drugs (ATDs) are commonly used for its treatment, but the predictors of remission and factors associated with a positive response to ATD therapy are not fully understood.

Methods: A retrospective study was conducted using medical records of 64 patients diagnosed with GD at a hospital in Saudi Arabia. Demographic characteristics, thyroid-related factors, ATD treatment details, and remission rates data were collected. Statistical analysis was performed using univariate association tests and multivariable logistic regression models.

Results: The majority of participants were females, with a median age of 38 years. Smoking history was reported in 28.9% of patients. Methimazole (MMI) was the predominant ATD used. The remission rate with ATD treatment was 62.5%. In terms of predictors of remission, 50% of female participants achieved remission compared to 94.4% of male participants (p < 0.01). The body mass index was 26.4 in the remitted group compared to 30.4 in those not achieving remission (p = 0.028). The maximum TSH level while on treatment exhibited significant association as the remitted group had higher maximum TSH levels (median 6.5) compared to the non-remitted group (median 1.2) (p = 0.010).

Conclusion: The study highlights the common use of MMI as the primary antithyroid drug and the positive remission outcomes in most patients. Male gender, lower BMI, and higher maximum TSH levels on treatment were predictors of remission. More research with larger samples and longer follow-up is needed.

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