Clinical factors influencing the success rate of radioiodine treatment for Graves' disease

• Published in: Diabetes, obesity & metabolism obesity & metabolism, 2024-10, Vol.26 (10), p.4397-4409
• Main Authors: He, Meiwen, Pan, Limeng, Li, Yifan, Wang, Yue, Zhong, Xing, Du, Yijun, Pan, Tianrong
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antithyroid Agents - therapeutic use; Female; Graves disease; Graves Disease - drug therapy; Graves Disease - radiotherapy; Humans; influencing factors iodine dose per unit volume; Iodine; Iodine Radioisotopes - therapeutic use; Male; Medical treatment; Middle Aged; Patients; RAI; Regression analysis; Retrospective Studies; Success; survival analysis; Thyroid; Thyroid gland; Treatment Outcome; Young Adult
• ISSN: 1462-8902; 1463-1326; 1463-1326
• DOI: 10.1111/dom.15790

Aims To investigate the impact of various clinical factors associated with Graves' disease on the success rate of radioiodine (RAI) therapy for Graves' disease within 3 years, and to determine the optimal range of iodine dosage per unit volume that yields the highest cure rate for Graves' disease within 1 year. Materials and Methods This retrospective study included patients diagnosed with Graves' disease who underwent RAI therapy at the Second Affiliated Hospital of Anhui Medical University between October 2012 and October 2022. The cumulative success rate was analysed using the Kaplan–Meier method. Univariate and multivariate Cox proportional hazards regression models were employed to evaluate factors associated with successful treatment of Graves' disease. Outcomes were categorized as either success or failure for all patients. Results Overall, 1994 patients were enrolled in this study, including 594 (29.8%) male and 1399 (70.2%) female patients. The success and failure groups comprised 1645 (82.4%) and 349 patients (17.6%), respectively, after a 3‐year follow‐up period. Multivariate regression analysis demonstrated that sex, antithyroid drug (ATD) use before RAI therapy, age, thyroid receptor antibody (TRAb) levels, iodine dose, thyroid mass, and early ATD use before RAI therapy were independent influencing factors for Graves' disease cure. Conclusions We found that female patients and those with TRAbs ≥31.83 IU/L and thyroid mass ≥ 73.42 g had a lower cure rate. Therefore, thyroid size, disease severity, and duration of disease should be comprehensively considered when making treatment decisions and iodine dose selection in clinical practice.