Does adding thyroxine (T4) to the thyroid inhibitor methimazole decrease relapse following withdrawal of antithyroid drugs?
Relapse rates following withdrawal of antithyroid drugs range from 10% to 75%, with no good predictors of which patients are likely to relapse. Unfortunately, new research does not provide a definitive answer, Dr. Hart said. A 1991 New England Journal of Medicine article found a 3% relapse after three years in patients with T4 added to methimazole, compared to a 33% relapse rate in patients on methimazole alone. A Scottish paper found no difference. We need to keep watching, Dr. Hart concluded. • Is pretreatment to euthyroidism before 131I treatment dangerous? Despite extremely limited data, many physicians pretreat for several weeks for fear radiation thyroiditis will release thyroid hormones into the circulation, leading to an immediate increase in the severity of hyperthyroidism. This could have disastrous effects on patients already at high risk. But Dr. Hart cited a new study by panel co-member Leonard Wartofsky, MACP, chairman of the department of medicine at Washington (D.C.) Ho
