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Endocrine Abstracts (2016) 44 P240 | DOI: 10.1530/endoabs.44.P240

SFEBES2016 Poster Presentations Thyroid (26 abstracts)

Epidemiology, management and outcomes of Graves’ disease in a U.K. Population – a Retrospective Cohort Study

Yusuf Hussain 1 , Jessica Hookham 1 , Amit Allahabadia 1, & Sapabathy Balasubramanian 1,

1University of Sheffield, Sheffield, UK; 2Royal Hallamshire Hospital, Sheffield, UK.

Background: Graves’ disease is the commonest cause of hyperthyroidism. Although first line and definitive treatment options are clearly defined, management practices and the natural history in terms of outcomes of treatment in a large consecutive cohort of Graves’ disease has not been well characterised.

Aims: To describe incidence, presentation, diagnosis, management strategies and medium term outcomes following anti-thyroid drug treatment, radio-iodine ablation and surgery in a consecutive cohort of patients presenting with Graves’ disease.

Methods: Retrospective cohort study of all patients (n=659) who received treatment for a new diagnosis of Graves’ disease in secondary care over a five year period. Median (IQR) follow up was 42.9 (29.0–57.5) months.

Results: Incidence of adult onset Graves’ disease was 24.8 per 100,000 per year (11.0 and 37.9 for males and females respectively). TRAb was positive in 91.7% (n=341) and TPO in 73.1% (n=236). 93.1% (n=581) achieved initial control with thionamide medication and 73.1% (n=428) achieved remission. At last follow up, 36.7% (n=157) relapsed. The risk of relapse was higher in patients who received block and replace therapy (P=0.013) versus titration, TRAb positive patients (P=0.035) and those with higher pre-treatment FT3 (P<0.001) and FT4 (P<0.001) levels.

Of 144 patients who had RIA treatment, 5.6% (n=8) relapsed. Of 119 patients having surgery, 5.2% (n=6) had long term hypoparathyroidism and no one had documented long term RLN palsy. Surgery was performed more often in younger, female patients with more severe disease.

Conclusions: This is the first study to report incidence of Graves’ disease in a UK population. In the short to medium term, 39.9% (n=263) of patients required surgery or RIA; both of which have little morbidity. Up to two-thirds of patients who achieved remission did not relapse. This information on effectiveness of various treatments for Graves’ disease will help clinicians and patients in decision making.

Volume 44

Society for Endocrinology BES 2016

Brighton, UK
07 Nov 2016 - 09 Nov 2016

Society for Endocrinology 

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