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Treatment of patients with Graves’ disease in Sweden compared to international surveys of an ‘index patient’

Sjölin, Gabriel ; Byström, Kristina ; Holmberg, Mats ; Törring, Ove ; Khamisi, Selwan ; Calissendorff, Jan ; Lantz, Mikael LU ; Hallengren, Bengt LU ; Filipsson Nyström, Helena and Planck, Tereza LU , et al. (2021) In Endocrinology, Diabetes and Metabolism 4(3).
Abstract

Introduction: The treatment strategies for a 42-year-old female index patient with moderate Graves’ disease (GD) vary according to several international surveys. The important question whether surveys of treatment preferences in theoretical patient cases also match how real patients are treated has not yet been addressed. Materials and Methods: From a Swedish cohort of 1186 GD patients (TT-12 cohort), 27 women were identified using the same criteria as from the index patient surveys from the European and American Thyroid Associations. This ‘index patient cohort’ was age 40–45, otherwise healthy female, with two children and uncomplicated GD. The applied first-line treatment of the patients in the index cohort, together with its... (More)

Introduction: The treatment strategies for a 42-year-old female index patient with moderate Graves’ disease (GD) vary according to several international surveys. The important question whether surveys of treatment preferences in theoretical patient cases also match how real patients are treated has not yet been addressed. Materials and Methods: From a Swedish cohort of 1186 GD patients (TT-12 cohort), 27 women were identified using the same criteria as from the index patient surveys from the European and American Thyroid Associations. This ‘index patient cohort’ was age 40–45, otherwise healthy female, with two children and uncomplicated GD. The applied first-line treatment of the patients in the index cohort, together with its variations, was compared with the treatment preferences according to international surveys. A comparison with the TT-12 cohort was also performed. Results: In the ‘Index cohort’, 77.8% were treated with antithyroid drugs (ATD), and 22.2% were treated with radioiodine (131I). This preference for ATD is in line with most countries/regions, with the exception of USA and the Middle East/North Africa, where 131I was preferred. The distribution of treatment in the TT-12 cohort did not significantly differ from the index cohort. ATD was the preferred treatment in male and young (age 19–22) patients, as was RAI in old (age 69–73) patients. The age-related, but not the gender-related, cases differed significantly from the entire TT-12 cohort. Conclusion: The treatment choice in an index patient in Sweden seems in line with European practice, where ATD is the preferred first choice. This differs compared to US and North African survey intentions, where 131I is more often used. Age more than gender influences the treatment choice of GD patients. This is, to our best knowledge, the first time an index patient from ‘real life’ has been presented and compared to treatment preferences of international thyroid association surveys.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
antithyroid drugs, Graves’ disease, hyperthyroidism, index patient, international surveys, long-term follow-up, radioactive iodine, thyroidectomy, treatment options
in
Endocrinology, Diabetes and Metabolism
volume
4
issue
3
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:34277969
  • scopus:85102514003
ISSN
2398-9238
DOI
10.1002/edm2.244
language
English
LU publication?
yes
id
cce02fda-fb82-4741-9c57-b0635b1a7b48
date added to LUP
2021-03-29 12:42:44
date last changed
2024-04-06 01:10:33
@article{cce02fda-fb82-4741-9c57-b0635b1a7b48,
  abstract     = {{<p>Introduction: The treatment strategies for a 42-year-old female index patient with moderate Graves’ disease (GD) vary according to several international surveys. The important question whether surveys of treatment preferences in theoretical patient cases also match how real patients are treated has not yet been addressed. Materials and Methods: From a Swedish cohort of 1186 GD patients (TT-12 cohort), 27 women were identified using the same criteria as from the index patient surveys from the European and American Thyroid Associations. This ‘index patient cohort’ was age 40–45, otherwise healthy female, with two children and uncomplicated GD. The applied first-line treatment of the patients in the index cohort, together with its variations, was compared with the treatment preferences according to international surveys. A comparison with the TT-12 cohort was also performed. Results: In the ‘Index cohort’, 77.8% were treated with antithyroid drugs (ATD), and 22.2% were treated with radioiodine (<sup>131</sup>I). This preference for ATD is in line with most countries/regions, with the exception of USA and the Middle East/North Africa, where <sup>131</sup>I was preferred. The distribution of treatment in the TT-12 cohort did not significantly differ from the index cohort. ATD was the preferred treatment in male and young (age 19–22) patients, as was RAI in old (age 69–73) patients. The age-related, but not the gender-related, cases differed significantly from the entire TT-12 cohort. Conclusion: The treatment choice in an index patient in Sweden seems in line with European practice, where ATD is the preferred first choice. This differs compared to US and North African survey intentions, where <sup>131</sup>I is more often used. Age more than gender influences the treatment choice of GD patients. This is, to our best knowledge, the first time an index patient from ‘real life’ has been presented and compared to treatment preferences of international thyroid association surveys.</p>}},
  author       = {{Sjölin, Gabriel and Byström, Kristina and Holmberg, Mats and Törring, Ove and Khamisi, Selwan and Calissendorff, Jan and Lantz, Mikael and Hallengren, Bengt and Filipsson Nyström, Helena and Planck, Tereza and Wallin, Göran}},
  issn         = {{2398-9238}},
  keywords     = {{antithyroid drugs; Graves’ disease; hyperthyroidism; index patient; international surveys; long-term follow-up; radioactive iodine; thyroidectomy; treatment options}},
  language     = {{eng}},
  number       = {{3}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Endocrinology, Diabetes and Metabolism}},
  title        = {{Treatment of patients with Graves’ disease in Sweden compared to international surveys of an ‘index patient’}},
  url          = {{http://dx.doi.org/10.1002/edm2.244}},
  doi          = {{10.1002/edm2.244}},
  volume       = {{4}},
  year         = {{2021}},
}