There are three major methods that are currently used for treatment of hyperthyroidism: medication (antithyroid drugs), radioiodine therapy and surgical intervention (thyroidectomy). In 2010, a systematic review of literature was done (B. Nygaard) with the purpose to find out, what kind of results can be expected in case of one or another method of hyperthyroidism treatment. 15 systemic reviews, randomized controlled trials (RCT), and observational studies complying with inclusion criteria were found.
The analysis showed that it is more effective to use carbimazole for 18 months compared to similar 6-month treatment (the recurrence rate within 1.5 years was 37% vs 58%, relative risk 0.42 at 95% confidence interval between 0.18 and 0.96). With therapy duration over 18 month, the statistical confidence of this difference was lost. This is reflected in clinical recommendations - 12 to 18 months of antithyroid drug treatment is recognized as an optimal treatment duration today. As to the tolerance to different antithyroid drugs, it was shown that the prevalence rate of rash with the use of carbimazole was lower compared to thiamazole: 7% (49/722) and 11% (82/714) respectively.
Prepared by Natalia Mishchenko
Published in the thematic issue «Diabetology. Thyroidology. Metabolic Disorders» No.1(25)' 2014
