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

Pages : 83-89

View : 15 | Download : 29

Publication Date : 2025-04-30

Article Type : Research Paper

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 (p=0.542), but higher TRAb levels at ATD discontinuation (p=0.026), larger thyroid volumes (p=0.043), and lower TSH levels at diagnosis (p=0.027) were related with increased relapse risk. In the whole patient group, GH relapse was lower in those treated with corticosteroids as GO therapy (p=0.030). The regression model identified thyroid volume (p=0.044) and corticosteroid usage for GO (p=0.042) 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.
Keywords : antitiroid ilaç, Graves orbitopatisi, hipertiroidi, kortikosteroid tedavi, tirotoksikoz