Glucocorticoids Are Preferable to Thionamides as First-Line Treatment for Amiodarone-Induced Thyrotoxicosis due to Destructive Thyroiditis: A Matched Retrospective Cohort Study (Articolo in rivista)

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  • Glucocorticoids Are Preferable to Thionamides as First-Line Treatment for Amiodarone-Induced Thyrotoxicosis due to Destructive Thyroiditis: A Matched Retrospective Cohort Study (Articolo in rivista) (literal)
Anno
  • 2009-01-01T00:00:00+01:00 (literal)
Alternative label
  • Fausto Bogazzi; Luca Tomisti; Giuseppe Rossi; Enrica Dell'Unto; Pasquale Pepe; Luigi Bartalena; and Enio Martino (2009)
    Glucocorticoids Are Preferable to Thionamides as First-Line Treatment for Amiodarone-Induced Thyrotoxicosis due to Destructive Thyroiditis: A Matched Retrospective Cohort Study
    in The Journal of clinical endocrinology and metabolism
    (literal)
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  • Fausto Bogazzi; Luca Tomisti; Giuseppe Rossi; Enrica Dell'Unto; Pasquale Pepe; Luigi Bartalena; and Enio Martino (literal)
Pagina inizio
  • 3757 (literal)
Pagina fine
  • 3762 (literal)
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  • 94 (literal)
Rivista
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  • 6 (literal)
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  • 10 (literal)
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  • ubMe (literal)
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  • Department of Endocrinology and Metabolism (F.B., L.T., E.D., E.M.), University of Pisa, 56124 Pisa,Italy; Department of Clinical Medicine, University of Insubria (L.B.), 21100 Varese, Italy; Unit of Epidemiology and Biostatistics, Institute of Clinical Physiology, National Research Council and G. Monasterio Foundation (G.R., P.P.), 56124 Pisa, Italy (literal)
Titolo
  • Glucocorticoids Are Preferable to Thionamides as First-Line Treatment for Amiodarone-Induced Thyrotoxicosis due to Destructive Thyroiditis: A Matched Retrospective Cohort Study (literal)
Abstract
  • Context: Type 2 amiodarone-induced thyrotoxicosis (AIT) is a destructive thyroiditis usually responsive to glucocorticoids; however, recent surveys showed that many expert thyroidologists worldwide use thionamides for type 2 AIT patients. Objective: The objective of the study was to compare the effectiveness of methimazole (MMI) or prednisone (GLU) in type 2 AIT patients who had a short cure time according to a published predictive model. Design: This was a matched retrospective cohort study. Setting: The study was conducted at a university center. Patients: Forty-two untreated type 2 AIT patients with a predicted cure time ?40 d were divided into two groups (MMI and GLU groups). After matching for the predicted cure time, patients in the GLU group were selected in a 1:1 ratio to patients in the MMI group. Intervention: Patients were treated with GLU or MMI for 40 d. Patients still thyrotoxic after 40 d continued glucocorticoids if in the GLU group or were switched to prednisone (MMI-GLU group) if in the MMI group. Main Outcome Measure: Time and rate of cure (healing) at 40 d were measured. Results: Patients still thyrotoxic after 40 d were 23.8 ? 9.3% in the GLU group and 85.7 ? 7.6% in the MMI group (P ? 0.000). The GLU and MMI-GLU groups did not significantly differ in the nonhealing rate at 40 d (P ? 0.730). When patients in the MMI group were treated with glucocorticoids, 94.1% patients achieved euthyroidism within 40 d. However, the global median cure time (MMI period ? prednisone period) was longer (60 d, 95% confidence interval 53.5-66.5 d) in the MMI-GLU group than the GLU group (21 d, 95% confidence interval 15.1-26.9 d). Conclusions: Glucocorticoids are the first-line treatment in type 2 AIT, whereas thionamides play no role in this destructive thyroiditis. (literal)
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