Real-World Data on the Development of Relapse in  Graves' Disease from a Tertiary Referral Center

Tuğba Barlas; Berkay Hasmercan; Tuba Kapçı; Yıldırım Ülker; Mehmet Muhittin Yalçın; Ethem Turgay Cerit; Alev Eroğlu Altınova; Mujde Akturk; Füsun Baloş Törüner

Article Details

Real-World Data on the Development of Relapse in Graves' Disease from a Tertiary Referral Center

Authors:

Tuğba Barlas | Berkay Hasmercan | Tuba Kapçı | Yıldırım Ülker | Mehmet Muhittin Yalçın | Ethem Turgay Cerit | Alev Eroğlu Altınova | Mujde Akturk | Füsun Baloş Törüner

Publisher:

Zonguldak Bulent Ecevit University

Main Topics:

Endokrinoloji

Journal:

Batı Karadeniz Tıp Dergisi Vol.9 Issue 1, pp.83-89

Document Type:

Article

Publication Date:

4/2025

Document Language:

English

Document ID (Org No.):

2001347357

pISSN:

2822-4302

Keywords:

Abstract:

 Aim: We aimed to evaluate clinical and laboratory parameters that may predict relapse in patients who have received adequate antithyroid drug ATD therapy for Graves disease GD. Material and Methods: We included patients with GD who received ATD therapy for at least 12 months and were followed for at least 12 months after treatment. Patients were classified into relapse and non-relapse groups, and their demographical, laboratory, imaging findings, and follow-up information were recorded retrospectively. Results: Eighty-three patients were included, with a median treatment duration of 18 13-24 month. Graves orbitopathy GO was present in 58 69.9 of patients, and 17 20.5 received steroid therapy for GO. Relapse occurred in 27 32.5 of patients, with a median time to relapse of 22 6-60 months, and 11 40.7 relapsed within the first 12 months. No association was found between TRAb positivity at diagnosis and relapse p0.542, but higher TRAb levels at ATD discontinuation p0.026, larger thyroid volumes p0.043, and lower TSH levels at diagnosis p0.027 were related with increased relapse risk. In the whole patient group, GH relapse was lower in those treated with corticosteroids as GO therapy p0.030. The regression model identified thyroid volume p0.044 and corticosteroid usage for GO p0.042 as predictors of relapse. Conclusion: Our findings suggest that while GH relapse might be more frequent in patients with larger thyroid volumes, corticosteroid therapy administered for GO may serve as a protective factor for GH relaps. The real-world data from our tertiary referral center may contribute to studies on GD relapse development, especially when considering sociodemographical differences.

 Aim: We aimed to evaluate clinical and laboratory parameters that may predict relapse in patients who have received adequate antithyroid drug ATD therapy for Graves disease GD. Material and Methods: We included patients with GD who received ATD therapy for at least 12 months and were followed for at least 12 months after treatment. Patients were classified into relapse and non-relapse groups, and their demographical, laboratory, imaging findings, and follow-up information were recorded retrospectively. Results: Eighty-three patients were included, with a median treatment duration of 18 13-24 month. Graves orbitopathy GO was present in 58 69.9 of patients, and 17 20.5 received steroid therapy for GO. Relapse occurred in 27 32.5 of patients, with a median time to relapse of 22 6-60 months, and 11 40.7 relapsed within the first 12 months. No association was found between TRAb positivity at diagnosis and relapse p0.542, but higher TRAb levels at ATD discontinuation p0.026, larger thyroid volumes p0.043, and lower TSH levels at diagnosis p0.027 were related with increased relapse risk. In the whole patient group, GH relapse was lower in those treated with corticosteroids as GO therapy p0.030. The regression model identified thyroid volume p0.044 and corticosteroid usage for GO p0.042 as predictors of relapse. Conclusion: Our findings suggest that while GH relapse might be more frequent in patients with larger thyroid volumes, corticosteroid therapy administered for GO may serve as a protective factor for GH relaps. The real-world data from our tertiary referral center may contribute to studies on GD relapse development, especially when considering sociodemographical differences.

 Aim: We aimed to evaluate clinical and laboratory parameters that may predict relapse in patients who have received adequate antithyroid drug ATD therapy for Graves disease GD. Material and Methods: We included patients with GD who received ATD therapy for at least 12 months and were followed for at least 12 months after treatment. Patients were classified into relapse and non-relapse groups, and their demographical, laboratory, imaging findings, and follow-up information were recorded retrospectively. Results: Eighty-three patients were included, with a median treatment duration of 18 13-24 month. Graves orbitopathy GO was present in 58 69.9 of patients, and 17 20.5 received steroid therapy for GO. Relapse occurred in 27 32.5 of patients, with a median time to relapse of 22 6-60 months, and 11 40.7 relapsed within the first 12 months. No association was found between TRAb positivity at diagnosis and relapse p0.542, but higher TRAb levels at ATD discontinuation p0.026, larger thyroid volumes p0.043, and lower TSH levels at diagnosis p0.027 were related with increased relapse risk. In the whole patient group, GH relapse was lower in those treated with corticosteroids as GO therapy p0.030. The regression model identified thyroid volume p0.044 and corticosteroid usage for GO p0.042 as predictors of relapse. Conclusion: Our findings suggest that while GH relapse might be more frequent in patients with larger thyroid volumes, corticosteroid therapy administered for GO may serve as a protective factor for GH relaps. The real-world data from our tertiary referral center may contribute to studies on GD relapse development, especially when considering sociodemographical differences.

 Amaç: Graves Hastalığı GH için yeterli antitiroid ilaç ATİ tedavisi almış hastalarda nüksü öngördürebilecek klinik ve laboratuvar parametrelerini değerlendirmeyi amaçladık. Gereç ve Yöntemler: En az 12 ay boyunca ATİ tedavisi almış ve tedavi sonrası en az 12 ay takip edilmiş GH olan hastalar çalışmaya dahil edildi. Hastalar, nüks ve nüks olmayan gruplar olarak sınıflandırıldı. Hastaların demografik, laboratuvar, görüntüleme bulguları ile takip verileri retrospektif olarak kaydedildi. Bulgular: Toplam 83 hasta çalışmaya dahil edildi ve medyan tedavi süresi 18 13-24 aydı. Hastaların 58 69,9inde Graves orbitopatisi GO mevcuttu ve 17 20,5si GO için steroid tedavisi almıştı. Hastaların 27 32,5sinde nüks gelişmişti ve nükse kadar geçen süre medyan 22 6-60 aydı. Nüks gelişen hastaların 11 40,7sinde nüks ilk 12 ay içinde gelişmişti. Tanı sırasındaki TRAb pozitifliği ile nüks gelişimi arasında bir ilişki bulunmadı p0,542, ancak ATİ tedavisinin kesilmesi sırasında daha yüksek TRAb seviyeleri p0,026, daha büyük tiroid hacmi p0,043, ve tanı anında daha düşük TSH seviyeleri p0,027 artmış nüks riski ile ilişkili bulundu. Tüm hasta grubunda GO tedavisi olarak steroid uygulananlarda GH nüks sıklığı daha düşüktü p0,030. Regresyon modelinde, tiroid hacmi p0,044 ve GO için kortikosteroid kullanımı p0,042 nüks gelişimi ile ilişkili faktörler olarak saptandı. Sonuç: Tiroid hacmi daha yüksek olanlarda GH nüksü daha fazla gözlenebilirken, GOda uygulanan kortikosteroid tedavisi nüks gelişimi üzerinde koruyucu bir faktör olabilir. Bulgularımız, özellikle sosyodemografik farklılıklar göz önünde bulundurulduğunda, GHde nüks gelişimi üzerine yapılan çalışmalara ek katkı sağlayabilir.

Article Details

Real-World Data on the Development of Relapse in Graves' Disease from a Tertiary Referral Center

Authors:

Tuğba Barlas | Berkay Hasmercan | Tuba Kapçı | Yıldırım Ülker | Mehmet Muhittin Yalçın | Ethem Turgay Cerit | Alev Eroğlu Altınova | Mujde Akturk | Füsun Baloş Törüner

Publisher:

Zonguldak Bulent Ecevit University

Main Topics:

Endokrinoloji

Journal:

Batı Karadeniz Tıp Dergisi Vol.9 Issue 1, pp.83-89

Document Type:

Article

Publication Date:

4/2025

Document Language:

English

Document ID (Org No.):

2001347357

pISSN:

2822-4302

antithyroid drugs

corticosteroid therapy

Graves’ orbitopathy

hyperthyroidism

thyrotoxicosisantitiroid ilaç

Graves orbitopatisi

hipertiroidi

kortikosteroid tedavi

tirotoksikoz

Issues

Article Details

Authors: Tuğba Barlas | Berkay Hasmercan | Tuba Kapçı | Yıldırım Ülker | Mehmet Muhittin Yalçın | Ethem Turgay Cerit | Alev Eroğlu Altınova | Mujde Akturk | Füsun Baloş Törüner

Publisher: Zonguldak Bulent Ecevit University

Main Topics: Endokrinoloji

Journal: Batı Karadeniz Tıp Dergisi Vol.9 Issue 1, pp.83-89

Document Type: Article

Publication Date: 4/2025

Document Language: English

Document ID (Org No.): 2001347357

pISSN: 2822-4302

Issues

Authors:

Tuğba Barlas | Berkay Hasmercan | Tuba Kapçı | Yıldırım Ülker | Mehmet Muhittin Yalçın | Ethem Turgay Cerit | Alev Eroğlu Altınova | Mujde Akturk | Füsun Baloş Törüner

Publisher:

Zonguldak Bulent Ecevit University

Main Topics:

Endokrinoloji

Journal:

Batı Karadeniz Tıp Dergisi Vol.9 Issue 1, pp.83-89

Document Type:

Article

Publication Date:

4/2025

Document Language:

English

Document ID (Org No.):

2001347357

pISSN:

2822-4302