Ikeoluwapo Kendra Bolakale-Rufai, Imodoye Abioro, Samuel Osobuchi Ngene, Yohannes Woldeamanuel
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引用次数: 0
摘要
背景：抗甲状腺药物联合放射性碘治疗巴塞杜氏病的疗效仍存在争议：抗甲状腺药物联合放射性碘治疗巴塞杜氏病的疗效仍存在争议：比较在使用放射性碘治疗巴塞杜氏病之前使用甲巯咪唑进行预处理的疗效：在尼日利亚伊巴丹的一家教学/三甲医院进行了系统综述和荟萃分析：方法：对PubMed、Embase、Cochrane Library和Web of Science数据库进行了系统性检索，检索期从开始到2021年12月：结果：共纳入五项研究，297 名参与者。与单独使用放射性碘相比，放射性碘与甲巯咪唑联合使用时发生持续性甲亢的风险没有差异（相对风险：1.02，95% 置信区间：0.62-1.66；P = 0.95，I2 = 0%）。根据停用甲巯咪唑和使用放射性碘之间的持续时间进行的亚组分析表明，在使用放射性碘前7天内停用甲巯咪唑的患者发生持续性甲亢的风险较低，但未达到统计学意义（风险比：0.85，CI：0.28-2.58）：结论：在使用放射性碘之前使用甲巯咪唑与持续性甲状腺功能亢进的风险增加无关。临床医生在决定采用联合疗法治疗巴塞杜氏病时，应考虑到对药物毒性和不良反应的担忧：CRD42020150013，https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=150013。
Efficacy of methimazole before the administration of radioactive iodine in the management of Graves' disease: a systematic review and meta-analysis.
Background: The efficacy of anti-thyroid drugs in conjunction with radioactive iodine therapy in the management of Graves' disease is still controversial.
Objective: To compare the efficacy of pretreatment with methimazole before the administration of radioactive iodine for the treatment of Graves' disease.
Design and setting: A systematic review and meta-analysis was conducted at a teaching/tertiary hospital in Ibadan, Nigeria.
Methods: A systematic search of the PubMed, Embase, Cochrane Library, and Web of Science databases was performed from inception to December, 2021.
Results: Five studies with 297 participants were included. There was no difference in the risk of persistent hyperthyroidism when radioactive iodine was used in conjunction with methimazole compared with when radioactive iodine was used alone (relative risk: 1.02, 95% confidence interval, CI: 0.62-1.66; P = 0.95, I2 = 0%). Subgroup analysis based on the duration between discontinuation of methimazole and the administration of radioactive iodine showed a lower risk of persistent hyperthyroidism when methimazole was discontinued within 7 days before radioactive iodine use, although this did not reach statistical significance (risk ratio: 0.85, CI: 0.28-2.58).
Conclusions: The use of methimazole before radioactive iodine administration was not associated with an increased risk of persistent hyperthyroidism. Concerns about medication toxicity and adverse effects should be considered when clinicians make decisions on combination therapies for the treatment of Graves' disease.
期刊介绍：
Published bimonthly by the Associação Paulista de Medicina, the journal accepts articles in the fields of clinical health science (internal medicine, gynecology and obstetrics, mental health, surgery, pediatrics and public health). Articles will be accepted in the form of original articles (clinical trials, cohort, case-control, prevalence, incidence, accuracy and cost-effectiveness studies and systematic reviews with or without meta-analysis), narrative reviews of the literature, case reports, short communications and letters to the editor. Papers with a commercial objective will not be accepted.
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