Key result
High-dose carbimazole shortens recovery of normal systolic time intervals by ~1.5 weeks versus 45 mg.
Why the study?
It was uncertain whether higher than conventional doses of carbimazole achieve more rapid control of thyrotoxicosis.
Does a higher than conventional dose of carbimazole (100 mg daily) achieve more rapid control of thyrotoxicosis compared to a conventional dose (45 mg daily) in thyrotoxic patients?
RCT (n=30)
Alternately allocated
Does a higher than conventional dose of carbimazole (100 mg daily) achieve more rapid control of thyrotoxicosis compared to a conventional dose (45 mg daily) in thyrotoxic patients?
Higher than conventional doses of carbimazole (100 mg daily) achieve more rapid control of peripheral thyroid hormone activity than standard doses (45 mg daily) without increasing short-term side effects.
Answers are grounded in this paper and cite their sources.
Higher-dose carbimazole accelerated STI normalization in thyrotoxicosis; small nonrandomized study leaves optimal initial dosing unresolved.
In order to ascertain whether higher than conventional doses of carbimazole achieve more rapid control of thyrotoxicosis, 30 thyrotoxic patients were alternately allocated into two groups, group 1 (15 subjects) receiving a conventional starting dose of 45 mg orally daily and group 2 (15 subjects) a dose of 100 mg orally. In addition to weekly estimations of serum T4, T3, free T4, free T3 and TSH, the systolic time intervals ratio (STI), a measure of left ventricular contractility, was calculated as an accurate measure of peripheral thyroid hormone activity, the study end-point being a normal STI (0.26-0.32). None of the individuals studied experienced side-effects during the study period. Mean pre-treatment STI values for the two treatment groups were the same at entry (0.20). The mean recovery times for STI was 4.4 weeks (SE 0.3) in the high dose group and 5.9 weeks (SE 0.4) in the low dose group (P = 0.0037). There was a definite trend towards a shorter recovery time for free T3 in the higher dose group (P = 0.057) but no apparent differences for T4, T3 and free T4. Higher than conventional doses of carbimazole may be advisable in the initial treatment of severe thyrotoxicosis.
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O'Malley et al. (1988) conducted an RCT in Thyrotoxicosis (n=30). Carbimazole vs. 45 mg orally daily was evaluated on Recovery time for normal systolic time intervals ratio (STI) (p=0.0037). High-dose carbimazole (100 mg daily) significantly shortened the mean recovery time for normal systolic time intervals compared to a 45 mg dose (4.4 vs 5.9 weeks, P=0.0037).
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