Control of Graves’ Hyperthyroidism with Very Long-Term Methimazole Treatment: A Clinical Trial

Mapping Intimacies ◽

10.21203/rs.3.rs-41877/v1 ◽

2020 ◽

Author(s):

Fereidoun Azizi ◽

Hengameh Abdi ◽

Atieh Amouzegar

Keyword(s):

Low Dose ◽

Reference Range ◽

Therapeutic Modality ◽

Antithyroid Drugs ◽

Thyroid Status ◽

Tsh Receptor Antibody ◽

Daily Dose ◽

Prevention Of Relapse

Abstract Background: Long-term antithyroid drugs therapy has become one of the options for treatment of Graves’ hyperthyroidism. The aim of this study was to compare thyroid status in those who discontinued methimazole (MMI) treatment after 12.8 years with those who continued MMI as long as 24 years.Methods: Fifty nine patients with Graves’ disease on long-term MMI for 14.2±2.9 years were recruited; 32 patients (54%) decided to discontinue MMI and 27 (46%) preferred additional years of MMI treatment. All patients were followed for a mean of 6 additional years.Results: Of 27 patients who continued MMI, 16 and 11 subjects completed median of 20 and 24 years of MMI treatment, respectively. Suppressed serum thyrotropin (TSH) was not observed in any patient after seventh years of treatment. Serum free thyroxine, triiodothyronine, TSH and TSH receptor antibody concentrations remained normal up to the length of the study. Mean daily dose of MMI to maintain TSH in the reference range decreased gradually and reached to 2.8±1.7 mg by 24 years of MMI treatment. No adverse reaction related to MMI occured during additional years of therapy. In 32 patients who discontinued MMI, hyperthyroidism relapsed in 6 patients (19%), one left follow-up and 25 (78%) remained euthyroid during the study.Conclusions: Long-term low dose MMI treatment may be a lifelong effective and safe therapeutic modality in patients with Graves’ hyperthyroidism for prevention of relapse.Trial registration: IRCT201009224794N, 2010-10-25. Retrospectively registered.www. IRCT.IR/Trial/5143.

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Control of Graves’ hyperthyroidism with very long-term methimazole treatment: A clinical trial

10.21203/rs.3.rs-41877/v3 ◽

2021 ◽

Author(s):

Fereidoun Azizi ◽

Hengameh Abdi ◽

Atieh Amouzegar

Keyword(s):

Low Dose ◽

Reference Range ◽

Therapeutic Modality ◽

Antithyroid Drugs ◽

Thyroid Status ◽

Tsh Receptor Antibody ◽

Daily Dose ◽

Prevention Of Relapse

Abstract Background: Long-term antithyroid drugs therapy has become one of the options for treatment of Graves’ hyperthyroidism. The aim of this study was to compare thyroid status in those who discontinued methimazole (MMI) treatment after 12.8 years with those who continued MMI as long as 24 years.Methods: Fifty nine patients with Graves’ disease on long-term MMI for 14.2±2.9 years were recruited; 32 patients (54%) decided to discontinue MMI and 27 (46%) preferred additional years of MMI treatment. All patients were followed for a mean of 6 additional years.Results: Of 27 patients who continued MMI up to 24 years, suppressed serum thyrotropin (TSH) was not observed in any patient after the seventh year of treatment. Serum free thyroxine, triiodothyronine, TSH and TSH receptor antibody concentrations remained normal up to the length of the study. Mean daily dose of MMI to maintain TSH in the reference range decreased gradually and reached to 2.8±1.7 mg by 24 years of MMI treatment. No adverse reaction related to MMI occured during additional years of therapy. In 32 patients who discontinued MMI, hyperthyroidism relapsed in 6 patients (19%), one left follow-up and 25 (78%) remained euthyroid during the study.Conclusions: Long-term low dose MMI treatment may be a lifelong effective and safe therapeutic modality in patients with Graves’ hyperthyroidism for prevention of relapse, if studies from other centers confirm findings of this research.Trial registration: IRCT201009224794N1, 2010-10-25. Retrospectively registered.www. IRCT.IR/Trial/5143.

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Control of Graves’ hyperthyroidism with very long-term methimazole treatment: A clinical trial

10.21203/rs.3.rs-41877/v2 ◽

2020 ◽

Author(s):

Fereidoun Azizi ◽

Hengameh Abdi ◽

Atieh Amouzegar

Keyword(s):

Low Dose ◽

Reference Range ◽

Therapeutic Modality ◽

Antithyroid Drugs ◽

Thyroid Status ◽

Tsh Receptor Antibody ◽

Daily Dose ◽

Prevention Of Relapse

Abstract Background: Long-term antithyroid drugs therapy has become one of the options for treatment of Graves’ hyperthyroidism. The aim of this study was to compare thyroid status in those who discontinued methimazole (MMI) treatment after 12.8 years with those who continued MMI as long as 24 years.Methods: Fifty nine patients with Graves’ disease on long-term MMI for 14.2±2.9 years were recruited; 32 patients (54%) decided to discontinue MMI and 27 (46%) preferred additional years of MMI treatment. All patients were followed for a mean of 6 additional years.Results: Of 27 patients who continued MMI, 16 and 11 subjects completed median of 20 and 24 years of MMI treatment, respectively. Suppressed serum thyrotropin (TSH) was not observed in any patient after seventh years of treatment. Serum free thyroxine, triiodothyronine, TSH and TSH receptor antibody concentrations remained normal up to the length of the study. Mean daily dose of MMI to maintain TSH in the reference range decreased gradually and reached to 2.8±1.7 mg by 24 years of MMI treatment. No adverse reaction related to MMI occured during additional years of therapy. In 32 patients who discontinued MMI, hyperthyroidism relapsed in 6 patients (19%), one left follow-up and 25 (78%) remained euthyroid during the study.Conclusions: Long-term low dose MMI treatment may be a lifelong effective and safe therapeutic modality in patients with Graves’ hyperthyroidism for prevention of relapse, if studies from other centers confirm findings of this research.Trial registration: IRCT201009224794N, 2010-10-25. Retrospectively registered.www. IRCT.IR/Trial/5143.

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Control of Graves’ hyperthyroidism with very long-term methimazole treatment: a clinical trial

BMC Endocrine Disorders ◽

10.1186/s12902-020-00670-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Fereidoun Azizi ◽

Hengameh Abdi ◽

Atieh Amouzegar

Keyword(s):

Low Dose ◽

Reference Range ◽

Antithyroid Drug ◽

Therapeutic Modality ◽

Thyroid Status ◽

Antithyroid Drug Therapy ◽

Daily Dose ◽

Prevention Of Relapse

Abstract Background Long-term antithyroid drug therapy has become one of the options for treatment of Graves’ hyperthyroidism. The aim of this study was to compare thyroid status in those who discontinued methimazole (MMI) treatment after 12.8 years with those who continued MMI as long as 24 years. Methods Fifty nine patients with Graves’ disease on long-term MMI for 14.2 ± 2.9 years were recruited; 32 patients (54%) decided to discontinue MMI and 27 (46%) preferred additional years of MMI treatment. All patients were followed for a mean of 6 additional years. Results Of 27 patients who continued MMI up to 24 years, suppressed serum thyrotropin (TSH) was not observed in any patient after the seventh year of treatment. Serum free thyroxine, triiodothyronine, TSH and TSH receptor antibody concentrations remained normal up to the length of the study. Mean daily dose of MMI to maintain TSH in the reference range decreased gradually and reached to 2.8 ± 1.7 mg by 24 years of MMI treatment. No adverse reaction related to MMI occured during additional years of therapy. In 32 patients who discontinued MMI, hyperthyroidism relapsed in 6 patients (19%), one left follow-up and 25 (78%) remained euthyroid during the study. Conclusions Long-term low dose MMI treatment may be a lifelong effective and safe therapeutic modality in patients with Graves’ hyperthyroidism for prevention of relapse, if studies from other centers confirm findings of this research. Trial registration IRCT201009224794N1, 2010-10-25. Retrospectively registered. https://www.irct.ir/trial/5143.

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POS0338 STEROID-SPARING EFFECT OF ANAKINRA IN GIANT-CELL ARTERITIS: A CASE SERIES WITH CLINICAL, BIOLOGICAL AND ICONOGRAPHIC LONG-TERM ASSESSMENTS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.1623 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 397.1-397

Author(s):

S. Deshayes ◽

K. Ly ◽

V. Rieu ◽

G. Maigné ◽

N. M. Silva ◽

...

Keyword(s):

Giant Cell Arteritis ◽

Giant Cell ◽

Interleukin 1 ◽

Oral Prednisone ◽

Large Vessel ◽

Daily Dose ◽

Sparing Effect ◽

Steroid Sparing

Background:The treatment of giant cell arteritis (GCA) relies on corticosteroids but is burdened by a high rate of relapses and adverse effects. Anti-interleukin-6 treatments show a clear benefit with a significant steroid-sparing effect, but late relapses occur after treatment discontinuation. In addition to interleukin-6, interleukin-1 also appears to play a significant role in GCA pathophysiology.Objectives:We report herein the efficacy of anakinra, an interleukin-1 receptor antagonist, in 6 GCA patients exhibiting corticosteroid dependence or resistance, specifically analyzing the outcome of aortitis in 4 of them, and including the long-term follow-up of 2 previously described patients (1).Methods:This retrospective study analyzed the cases of all GCA patients treated with anakinra from the French Study Group for Large Vessel Vasculitis.Patients had to satisfy the following two criteria to be enrolled in this retrospective study. First, their diagnosis of GCA should be based on the fulfillment of at least 3 criteria of the American College of Rheumatology (ACR) for GCA or on the satisfaction of 2 of these criteria along with the demonstration of LVI on imaging. Second, patients should have received anakinra because of corticosteroid dependence or resistance.Corticosteroid dependence was defined as ≥2 relapses or the combination of 2 of the following criteria: a daily dose of oral prednisone >20 mg/day (or 0.3 mg/kg) at 6 months; a daily dose of oral prednisone >10 mg/day (or 0.2 mg/kg) at 12 months; and/or a treatment maintained >24 months because of a relapsing disease course. Corticosteroid resistance was defined as persistent increased inflammatory parameters at month 3 despite a steroid dosage over 0.5 mg/kg.Results:After a median duration of anakinra therapy of 19 [18–32] months, all 6 patients exhibited complete clinical and biological remission. Among the 4 patients with large-vessel involvement, 2 had a disappearance of aortitis under anakinra, and 2 showed a decrease in vascular uptake. After a median follow-up of 56 [48–63] months, corticosteroids were discontinued in 4 patients, and corticosteroid dosage could be decreased to 5 mg/day in 2 patients. One patient relapsed 13 months after anakinra introduction in the context of increasing the daily anakinra injection interval to every 48 hours. Three patients experienced transient injection-site reactions, and 1 patient had pneumonia.Figure 1.Steroid dosages before and after the introduction of anakinra in 6 patients with giant-cell arteritis and corticosteroid dependence or resistance. The black arrow indicates the time of anakinra introduction.Conclusion:In this short series, anakinra appears to be an efficient and safe steroid-sparing agent in refractory GCA, with a possible beneficial effect on large-vessel involvement.References:[1]Ly K-H, Stirnemann J, Liozon E, Michel M, Fain O, Fauchais A-L. Interleukin-1 blockade in refractory giant cell arteritis. Joint Bone Spine 2014;81:76–8.Disclosure of Interests:Samuel Deshayes: None declared, Kim LY: None declared, Virginie Rieu: None declared, Gwénola Maigné: None declared, Nicolas Martin Silva: None declared, Alain Manrique: None declared, Jacques Monteil: None declared, Hubert de Boysson Speakers bureau: Roche-Chugai, Grant/research support from: Roche-Chugai, Achille Aouba Grant/research support from: SOBI

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LOW-DOSE HEPATITIS B IMMUNOGLOBULIN GIVEN “ON DEMAND” IN COMBINATION WITH LAMIVUDINE: A HIGHLY COST-EFFECTIVE APPROACH TO PREVENT RECURRENT HEPATITIS B VIRUS INFECTION IN THE LONG-TERM FOLLOW-UP AFTER LIVER TRANSPLANTATION

Transplantation Journal ◽

10.1097/01.tp.0000118904.63669.eb ◽

2004 ◽

Vol 77 (8) ◽

pp. 1203-1208 ◽

Cited By ~ 45

Author(s):

Daniele Di Paolo ◽

Giuseppe Tisone ◽

Paola Piccolo ◽

Ilaria Lenci ◽

Settimio Zazza ◽

...

Keyword(s):

Hepatitis B ◽

Low Dose ◽

Cost Effective ◽

Recurrent Hepatitis ◽

Cost Effective Approach ◽

B Virus ◽

Long Term Follow Up ◽

Hepatitis B Immunoglobulin

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Long Term follow up of low dose metformin in prediabetic patients

10.26226/morressier.617c37317c09fc044a975276 ◽

2021 ◽

Author(s):

Oscar Natan

Keyword(s):

Low Dose ◽

Long Term Follow Up

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Low-Dose Anti-Thyroid Medication in Graves Disease: Assessment of the Efficacy Based on a Long-Term Follow-Up (Interim Report)

10.1210/endo-meetings.2011.part2.p17.p1-684 ◽

2011 ◽

pp. P1-684-P1-684

Author(s):

Hamid Reza Bazrafshan ◽

Friedrich Fitz ◽

Martin Steinmair ◽

Clemens Reichl ◽

Mohsen Beheshti ◽

...

Keyword(s):

Low Dose ◽

Disease Assessment ◽

Graves Disease ◽

Interim Report ◽

Thyroid Medication ◽

Long Term Follow Up

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Gamma Knife radiosurgery for skull base meningioma: long-term results of low-dose treatment

Journal of Neurosurgery ◽

10.3171/jns/2008/109/11/0804 ◽

2008 ◽

Vol 109 (5) ◽

pp. 804-810 ◽

Cited By ~ 65

Author(s):

Yoshiyasu Iwai ◽

Kazuhiro Yamanaka ◽

Hidetoshi Ikeda

Keyword(s):

Malignant Transformation ◽

Gamma Knife ◽

Low Dose ◽

Gamma Knife Radiosurgery ◽

Cranial Base ◽

Local Failure ◽

Long Term Results ◽

Early Results

Object In this study, the authors evaluate the long-term results after Gamma Knife radiosurgery of cranial base meningiomas. This study is a follow-up to their previously published report on the early results. Methods Between January 1994 and December 2001, the authors treated benign cranial base meningiomas in 108 patients using low-dose Gamma Knife radiosurgery. The tumor volumes ranged from 1.7 to 55.3 cm3 (median 8.1 cm3), and the radiosurgery doses ranged from 8 to 12 Gy (median 12 Gy) to the tumor margin. Results The mean duration of follow-up was 86.1 months (range 20–144 months). Tumor volume decreased in 50 patients (46%), remained stable in 51 patients (47%), and increased (local failure) in 7 patients (6%). Eleven patients experienced tumor recurrence outside the treatment field. Among these patients, marginal failure was seen in 5 and distant recurrence was seen in 6. Seven patients were thought to have malignant transformation based on histological or radiological characteristics of the lesion. The actuarial progression-free survival rate, including malignant transformation and outside recurrence, was 93% at 5 years and 83% at 10 years. Neurological status improved in 16 patients (15%). Permanent radiation injury occurred in 7 patients (6%). Conclusions Gamma Knife radiosurgery is a safe and effective treatment for cranial base meningiomas as demonstrated with a long-term follow-up period of > 7 years. Surgeons must be aware of the possibility of treatment failure, defined as local failure, marginal failure, and malignant transformation; however, this may be the natural course of meningiomas and not related to radiosurgery.

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