Efficacy of Antithyroid Drug Therapy Among Patients With Graves’ Disease: Results From a Tertiary Care Hospital in Chhattisgarh

Introduction: The clinical manifestations of Graves' disease and rates of remission with antithyroid drugs (ATDs) differ among populations. This study aimed to describe the clinical and laboratory features, to estimate the outcome of ATDs therapy, and to determine the factors affecting outcome among patients with Graves's disease presenting to a tertiary care hospital in central India. Methods: In this retrospective study, records of patients with first episode of adult-onset Graves' disease with treatment history of ≥12 months were reviewed. Results: 93 patients (66 female) aged 40.2 ± 12.5 years were included. Graves ophthalmopathy was observed in 14 (15.1%). All patients had received ATD as first line therapy (88 received Carbimazole). The starting dose of carbimazole was 28.1 ± 16.1 mg/day. The peak dose was 41.7 ± 23.3 mg/day. fT4 was restored to normal after 4.0 ± 4.0 months. After a follow up of 32.4 ± 25.8 months, ATD could be withdrawn in only 13 (14.0%) patients. The period of follow up after ATD withdrawal was 7 ± 7.5 months. While 3 of these patients relapsed within 6 months (median), 4 were in remission after ≥12 months. 66 (71.0%) patients continued to be in non-remission till the end of follow up, while 15 (16.4%) were either euthyroid or hypothyroid while on tapering or minimum maintenance dose of ATD. Grade of goiter, T3 and fT4 at diagnosis, and peak carbimazole dose were found to predict non-remission in univariable analysis. Discussion: Low prevalence of ophthalmopathy and low rates of remission in response to ATD was observed among Graves' disease patients from Central India.