# Effectiveness of Xiakucao Oral Liquid combined with methimazole on early thyroid function recovery and treatment compliance in Graves’ disease: a real-world retrospective cohort study

## TL;DR

This study finds that combining Xiakucao Oral Liquid with methimazole may help improve early thyroid function recovery in Graves’ disease patients.

## Contribution

The study evaluates the effectiveness of Xiakucao Oral Liquid combined with methimazole in a real-world setting for Graves’ disease.

## Key findings

- XKC+MMI was associated with a greater increase in sensitive thyroid-stimulating hormone compared to MMI alone.
- Continuous 3-month treatment with XKC+MMI was independently linked to improved sTSH levels.
- Only 13.3% of patients in the XKC+MMI group continued treatment for three months.

## Abstract

To evaluate the effectiveness and treatment compliance of Xiakucao Oral Liquid (XKC) combined with methimazole (MMI) on the early recovery of thyroid function in Graves’ disease (GD) patients.

In this retrospective cohort study, GD patients receiving initial treatment at Jieyang People’s Hospital from January 2019 to December 2023 were included and divided into XKC+MMI group and MMI group based on the treatment regimen. The association between XKC+MMI and early thyroid function recovery was analyzed using multiple linear regression in the subgroup of patients with post-treatment data available at 3 months.

A total of 441 patients were enrolled, among whom 113 (25.6%) patients received XKC+MMI. The proportion of patients receiving XKC+MMI was significantly higher with an initial MMI dose ≥20 mg/day than <20 mg/day (37.1% vs. 15.2%, P=0.006). In XKC+MMI group, 15 (13.3%) patients underwent continuous treatment with XKC for three months. Subgroup analysis (n=121) showed the increase of sensitive thyroid-stimulating hormone (sTSH) in XKC+MMI group was higher than that in MMI group (4.86 ± 11.7 vs 1.15 ± 5.16). Multivariate linear regression analysis indicated that compared with MMI alone, XKC+MMI was independently associated with the increase of sTSH (β=3.346, 95%CI: 0.353-6.339, P=0.031), and the continuous 3-month treatment of XKC+MMI was also independently associated with the increase of sTSH at 3 months (β=4.062, 95%CI: 0.516-7.608, P=0.027).

XKC combination MMI treatment might promote early recovery of thyroid function. However, adherence to and persistence with XKC treatment still need to be improved.