Management Aspects of Medical Therapy in Graves' Disease.

Abstract

Objective: Graves' disease is the most common cause of hyperthyroidism. Treatment options include antithyroid drugs, radioactive iodine, and surgery. In this review, we focus on the medical aspects of managing Graves' Disease.

Methods: Authors conducted a literature review of PubMed to include studies and review articles on Graves' disease management, antithyroid drugs, long term safety of antithyroid drugs, hyperthyroidism in pregnancy, Graves' ophthalmopathy and special circumstances related to hyperthyroidism.

Results: In adjunction to antithyroid drugs, medical management for Graves' disease also includes beta blockers, glucocorticoids, and iodine containing agents. Antithyroid drugs are currently the preferred option for initial management of Graves' disease, reflecting a shift in practice observed in the US over the past two decades. Antithyroid drugs in appropriate doses are well tolerated and safe when used for longer duration, during pregnancy and other circumstances discussed in this article. Routine thyroid function tests are important for monitoring. TRAb plays an essential role in determining duration of treatment and assessing the likelihood of recurrence.

Conclusion: Medical management of Graves' Disease with ATD is safe and effective. Long term use beyond 24 months in patients with elevated TRAb is a reasonable alternative option to surgery and RAI due to higher rates of remission.