格雷夫斯甲亢的治疗:一个多世纪的进展

IF 2.1 Q3 ENDOCRINOLOGY & METABOLISM International Journal of Endocrinology and Metabolism Pub Date : 2020-06-27 DOI:10.5812/ijem.103943
H. Abdi, A. Amouzegar
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引用次数: 3

摘要

背景:Graves病(GD)有三种治疗方式,包括甲状腺手术、放射性碘(RAI)和抗甲状腺药物(ATDs)。我们旨在简要回顾这些治疗策略的历史及其优缺点。证据获取:我们使用相关搜索词在PubMed中搜索英语文章。结果:GD的各种治疗方式各有优缺点。如今,ATDs是全球范围内最常用的GD处方治疗方法。由于缺乏设计良好的大型随机对照试验,比较三种不同的治疗甲状腺机能亢进的短期和长期结果,导致每种治疗方法的偏好存在显著的不确定性,这在不同协会的相关指南中是显而易见的。最近,长期使用ATDs的有效性和安全性已得到证实。结论:在医患讨论时应综合考虑Graves甲亢各种治疗方式的利弊,选择首选治疗方案。考虑到最近关于ATD的长期疗效和安全性的数据,似乎适当选择Graves患者进行长期ATD治疗可能是治疗甚至治愈GD的新途径。
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Management of Graves’ Hyperthyroidism: More Than a Century of Progression
Context: There are three therapeutic modalities for the management of Graves’ disease (GD), including thyroid surgery, radioactive iodine (RAI), and antithyroid drugs (ATDs). We aimed to briefly review the history of these treatment strategies and their advantages and disadvantages. Evidence Acquisition: We searched PubMed for English language articles using pertinent search terms. Results: Each treatment modality for GD is accompanied by several advantages and disadvantages. Nowadays, ATDs are the most commonly prescribed therapy for GD worldwide. The lack of well-designed, large RCTs comparing three different treatments for hyperthyroidism concerning various short-term and long-term outcomes has led to remarkable uncertainty in the preference of each of these treatments, as is evident in relevant guidelines from different societies. Recently, the efficacy and safety of long-term use of ATDs have been documented. Conclusions: Pros and cons of each therapeutic modality for Graves’ hyperthyroidism should be taken into account during the physician-patient discussion to select the primary treatment. Considering recent data about the long-term efficacy and safety of ATDs, it seems that the appropriate selection of Graves’ patients for long-term ATD therapy can be a new avenue in the treatment and even cure of GD.
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来源期刊
CiteScore
3.10
自引率
4.80%
发文量
0
期刊介绍: The aim of the International Journal of Endocrinology and Metabolism (IJEM) is to increase knowledge, stimulate research in the field of endocrinology, and promote better management of patients with endocrinological disorders. To achieve this goal, the journal publishes original research papers on human, animal and cell culture studies relevant to endocrinology.
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