Serum TSH level as predictor of Graves' disease recurrence following antithyroid drug withdrawal: A systematic review

Graves' disease (GD) has a high recurrence rate despite various and adequate treatment. Numerous studies have been performed to identify the predictor of disease recurrence. This report aims to investigate the role of thyroid stimulating hormone (TSH) level as a thyrotropin in predicting the re...

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Bibliographic Details
Published in:PloS one 2021-01, Vol.16 (1), p.e0245978-e0245978
Main Authors: Subekti, Imam, Kartiko, Gracia Jovita, Suhardi, Zahra Farhanni, Muhadi, Wisnu, Wismandari
Format: Article
Language:English
Subjects:
Antibodies
Bias
Biology and Life Sciences
Care and treatment
Cohort analysis
Confidence intervals
Criteria
Data collection
Development and progression
Diseases
Dosage and administration
Drug withdrawal
Endocrinology
Graves disease
Health aspects
Health risks
Hyperthyroidism
Internal medicine
Measurement
Medical prognosis
Medicine
Medicine and Health Sciences
Metabolism
Patient outcomes
Patients
Population
Quality assessment
Quality control
Relapse
Remission
Research and Analysis Methods
Risk factors
Systematic review
Thyroid antagonists
Thyroid gland
Thyrotropin
Urban populations
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Summary:Graves' disease (GD) has a high recurrence rate despite various and adequate treatment. Numerous studies have been performed to identify the predictor of disease recurrence. This report aims to investigate the role of thyroid stimulating hormone (TSH) level as a thyrotropin in predicting the recurrence of Graves' disease within 1 to 2 years following antithyroid drug (ATD) withdrawal. Literature searching was conducted on PubMed, Scopus, Cochrane, Proquest, EBSCO in August 2019 and Google Scholar in October 2020. The study criteria include the study that evaluates TSH level 4 weeks following ATD withdrawal, with subjects ≥18 years old who are retrospectively or prospectively followed up after 1 to 2 years following ATD withdrawal. Four eligible studies were selected based on inclusion/exclusion criteria, all of which measured TSH level at 4 weeks following ATD withdrawal. All studies had 1 to 2 years follow up. One study was an RCT, two studies were done in prospective cohort and another in retrospective cohort. All studies had comparable validity and applicability. Three out of four studies suggested that low TSH level measured 4 weeks following treatment withdrawal was associated with higher risk of disease recurrence. In conclusion, low TSH level obtained 4 weeks after ATD withdrawal was associated with higher rate of recurrence rate in GD.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0245978