Immunosuppressive therapy may reduce relapse risk in Graves’ disease
The addition of immunosuppressive drugs to the standard treatment of Graves’ disease may reduce the risk for relapse, according to study data.
Tristan Mirko Struja, MD, of the department of medicine at Kantonsspital Aarau in Switzerland, and colleagues evaluated seven randomized controlled trials with 862 participants to determine the effects of immunosuppressive drugs on relapse rate after a first episode of hyperthyroidism caused by Graves’ disease.
Participants of the studies were randomly assigned to immunosuppressive drugs or a control group.
Overall, there were 113 relapses among participants receiving immunosuppressive drugs compared with 225 among controls (RR = 0.55; 95% CI, 0.41-0.75); these results were similar for trials using corticosteroids alone (RR = 0.58; 95% CI, 0.41-0.83) and those using other immunosuppressants (RR = 0.42; 95% CI, 0.15-1.17).
Significant reductions in thyroid volume and thyroid-stimulating hormone receptor antibody levels were found among participants assigned immunosuppressive therapy compared with controls.
“There may be a significant reduction in relapse risk when immunosuppressive drugs were added to standard treatment of Graves’ disease,” the researchers wrote. “This effect was independent of type of immunosuppressive drug used and type of trial. There were also additional beneficial effects on thyroid volume and [TSH receptor antibody] associated with the interventional drugs used. Yet, the small number of trials with high heterogeneity in regard to type of drugs used and with mostly moderate to low quality calls for a large-scale randomized controlled trial to provide more definitive conclusions.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.