Treatment of patients with Graves’ disease in Sweden compared to international surveys of an ‘index patient’

Endocrinology, Diabetes & Metabolism

Tereza Planck¹  Mikael Lantz¹  Bengt Hallengren¹  Selwan Khamisi²  Kristina Byström³  Jan Calissendorff⁴  Gabriel Sjölin⁵  Göran Wallin⁵  Helena Filipsson Nyström⁶  Mats Holmberg⁶  Ove Törring⁷ 

[1] Department of Endocrinology Skåne University Hospital Malmö Sweden;Department of Endocrinology Uppsala University Hospital Uppsala Sweden;Department of Medicine Örebro University and University Hospital Örebro Sweden;Department of Molecular Medicine and Surgery Karolinska Institutet Stockholm Sweden;Faculty of Medicine and Health Örebro University Hospital Örebro Sweden;Institute of Medicine Sahlgrenska Academy University of Gothenburg Göteborg Sweden;Institution for Clinical Science and Education Karolinska Institutet Stockholm Sweden;

关键词: antithyroid drugs;    Graves’ disease;    hyperthyroidism;    index patient;    international surveys;    long‐term follow‐up;   

DOI  :  10.1002/edm2.244

来源: DOAJ

【 摘 要 】

Abstract Introduction The treatment strategies for a 42‐year‐old female index patient with moderate Graves’ disease (GD) vary according to several international surveys. The important question whether surveys of treatment preferences in theoretical patient cases also match how real patients are treated has not yet been addressed. Materials and Methods From a Swedish cohort of 1186 GD patients (TT‐12 cohort), 27 women were identified using the same criteria as from the index patient surveys from the European and American Thyroid Associations. This ‘index patient cohort’ was age 40–45, otherwise healthy female, with two children and uncomplicated GD. The applied first‐line treatment of the patients in the index cohort, together with its variations, was compared with the treatment preferences according to international surveys. A comparison with the TT‐12 cohort was also performed. Results In the ‘Index cohort’, 77.8% were treated with antithyroid drugs (ATD), and 22.2% were treated with radioiodine (131I). This preference for ATD is in line with most countries/regions, with the exception of USA and the Middle East/North Africa, where 131I was preferred. The distribution of treatment in the TT‐12 cohort did not significantly differ from the index cohort. ATD was the preferred treatment in male and young (age 19–22) patients, as was RAI in old (age 69–73) patients. The age‐related, but not the gender‐related, cases differed significantly from the entire TT‐12 cohort. Conclusion The treatment choice in an index patient in Sweden seems in line with European practice, where ATD is the preferred first choice. This differs compared to US and North African survey intentions, where 131I is more often used. Age more than gender influences the treatment choice of GD patients. This is, to our best knowledge, the first time an index patient from ‘real life’ has been presented and compared to treatment preferences of international thyroid association surveys.

【 授权许可】

Unknown