Total thyroid ablation improves course of Graves’ disease, surgeon says

PALM BEACH, Fla. — People with Graves’ disease may benefit from total thyroid ablation, according to a surgeon speaking here.

F. Menconi, MD, told attendees here at the American Thyroid Association meeting that this was the first randomized controlled study of total thyroid ablation.

As part of the study, 81 patients with moderate Graves’ disease were randomized to three types of thyroid treatment. One group was treated with methimazole, a second group was given a near-total thyroidectomy and a third group received a total thyroid ablation plus iodine-131. Patients in all three treatment groups also received glucocorticoid pulse therapy.

Dr. Menconi said a total of 69 patients completed the treatment and were followed for a minimum of 6 months. In all patients, proptosis, eyelid width, clinical activity score and diplopia were evaluated at baseline, 6 and 12 months.

At both follow-up points, proptosis was slightly reduced in all patient groups. Patients undergoing total thyroid ablation had a greater reduction in eyelid width than either remaining group.

“Diplopia improved or disappeared altogether in a greater proportion of patients treated with total thyroid ablation than in patients who were treated with methimazole or near-total thyroidectomy,” Dr. Menconi said. Furthermore, she noted that an overall positive response to the glucocorticoid treatment was more frequent in patients who underwent total thyroid ablation.

Dr. Menconi suggested a larger cohort group be included in future studies to verify her results.