A 2021 Suratthani Survey of Clinical Practice Patterns in the Management of Graves’ Disease
Keywords:
Graves’ disease, Pregnancy with Graves’ disease, Antithyroid drugAbstract
Background: Suratthani has minimal data on clinical practice trends in the assessment and treatment of Graves’ disease (GD).
Objectives: To evaluated the current diagnosis and management of GD in Suratthani.
Method: Suratthani’s medical doctors in 2021 were invited to participate in an electronic survey on management of GD between February and June 2021. Using the same index questionnaire as in previous surveys in North American and European.
Results: A total of 205 responses were included. The preferred diagnosis modality was blood test more than imaging. Serum Thyroid stimulating hormone (TSH) and Free T4 assays were the most frequently ordered measurements (99% and 91.7% respectively). Treatment with an antithyroid drug (ATD) was the preferred first choice of therapy (92.2%). Methimazole 15 mg/day with beta-blocker was the initial treatment of choice. In case of pregnancy, ATD (Propylthiouracil) was preferred in the first trimester which was similar to previous surveys.
Conclusion: Physician preferred for ATD in patients with uncomplicated GD. This was similar to European, North American and other Asian countries. The differences in treatment options may be caused by the limited availability of nuclear medicine facilities and experienced thyroid surgeons.
References
Shlomo M, Richard J, Allison B, Ronald J, Clifford J. Williams Textbook of Endocrinology. 14th ed. Philadelphia: Elsevier; 2019. p. 364-87.
Burch HB, Burman KD, Cooper DS. A 2011 survey of clinical practice patterns in the management of Graves' disease. The Journal of Clinical Endocrinology & Metabolism. 2012;97(12):4549-58.
Negro R, Attanasio R, Grimaldi F, Guglielmi R, Papini E. A 2015 Italian survey of clinical practice patterns in the management of Graves' disease: comparison with European and North American surveys. European thyroid journal. 2016;5(2):112-9.
Sriphrapradang C. Diagnosis and management of graves’ disease in Thailand: a survey of current practice. Journal of thyroid research. 2020;2020:1-8.
Jongjaroenprasert W, Akarawut W, Chantasart D, Chailurkit L, Rajatanavin R. Rectal administration of propylthiouracil in hyperthyroid patients: comparison of suspension enema and suppository form. Thyroid. 2002;12(7):627-31.
Alfadhli E, Gianoukakis AG. Management of severe thyrotoxicosis when the gastrointestinal tract is compromised. Thyroid. 2011;21(3):215-20.
Ross DS, Burch HB, Cooper DS, Greenlee MC, Laurberg P, Maia AL, et al. 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis. Thyroid. 2016;26(10):1343-421.
Bartalena L, Baldeschi L, Boboridis K, Eckstein A, Kahaly GJ, Marcocci C, et al. The 2016 European thyroid Association/European group on Graves' orbitopathy guidelines for the management of Graves' orbitopathy. European thyroid journal. 2016;5(1):9-26.
Alexander EK, Pearce EN, Brent GA, Brown RS, Chen H, Dosiou C, et al. 2017 Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum. Thyroid. 2017;27(3):315-89.
Association AT, Hyperthyroidism AAoCETo, Thyrotoxicosis OCo, Bahn RS, Burch HB, Cooper DS, et al. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Thyroid. 2011;21(6):593-646.
Bartalena L. Diagnosis and management of Graves disease: a global overview. Nature Reviews Endocrinology. 2013;9(12):724-34.
Smith TJ, Hegedüs L. Graves’ disease. New England Journal of Medicine. 2016;375(16):1552-65.
Bartalena L, Burch H, Burman K, Kahaly G. A 2013 European survey of clinical practice patterns in the management of Graves' disease. Clinical endocrinology. 2016;84(1):115-20.
Goichot B, Bouée S, Castello-Bridoux C, Caron P. Survey of clinical practice patterns in the management of 992 hyperthyroid patients in France. European thyroid journal. 2017;6(3):152-9.
Laurberg P, Bournaud C, Karmisholt J, Orgiazzi J. Management of Graves' hyperthyroidism in pregnancy: focus on both maternal and foetal thyroid function, and caution against surgical thyroidectomy in pregnancy. European journal of endocrinology. 2009;160(1):1-8
Andersen SL, Olsen J, Laurberg P. Antithyroid drug side effects in the population and in pregnancy. The Journal of Clinical Endocrinology & Metabolism. 2016;101(4):1606-14.
Acharya SH, Avenell A, Philip S, Burr J, Bevan JS, Abraham P. Radioiodine therapy (RAI) for Graves’ disease (GD) and the effect on ophthalmopathy: a systematic review. Clinical endocrinology. 2008;69(6):943-50.
