{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T20:30:19Z","timestamp":1783974619642,"version":"3.55.0"},"reference-count":21,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2016,8,1]],"date-time":"2016-08-01T00:00:00Z","timestamp":1470009600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Thionamides are associated with a high risk of recurrence following cessation. Thyrotropin receptor-stimulating antibody (TRAb) levels at diagnosis and\/or after thionamides may be biomarkers of this risk. This study assesses the natural history of Graves' thyrotoxicosis following thionamide withdrawal and factors that predict recurrence, particularly TRAb levels at diagnosis and cessation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      An observational study was conducted of patients with a first presentation of Graves' disease, who were prescribed (and completed) a course of primary thionamide treatment (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009266) in a university teaching hospital endocrine clinic. Recurrence rates over four years and factors predictive of recurrent thyrotoxicosis were assessed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The relapse rate was 31% at one year and 70% at four years. Younger age (39 years [range 30\u201349 years] vs. 47 years [range 37\u201353 years];\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.011), higher TRAb levels at diagnosis (8.8\u2009IU\/L [range 5.3\u201317.0\u2009IU\/L] vs. 5.7\u2009IU\/L [range 4.1\u20139.1\u2009IU\/L];\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.003), and higher TRAb levels at cessation of therapy (1.2\u2009IU\/L [range 0\u20132.3\u2009IU\/L] vs. &lt;0.9\u2009IU\/L [range 0\u20131.3\u2009IU\/L];\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.003) were associated with a higher risk of relapse. By four years, cessation TRAb &lt;0.9\u2009IU\/L was associated with a 58% risk of recurrence compared with 82% with TRAb &gt;1.5\u2009IU\/L (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.001). TRAb at diagnosis &gt;12\u2009IU\/L was associated with an 84% risk of recurrence over four years compared with 57% with TRAbs &lt;5\u2009IU\/L (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>High TRAb at diagnosis and\/or positive TRAb at cessation of therapy suggest a high likelihood of relapse, mostly within the first two years. They stratify patients likely to need definitive therapy (radioiodine or surgery).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/thy.2016.0017","type":"journal-article","created":{"date-parts":[[2016,6,7]],"date-time":"2016-06-07T23:52:46Z","timestamp":1465343566000},"page":"1004-1009","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":50,"title":["Thyrotropin Receptor Antibody Levels at Diagnosis and After Thionamide Course Predict Graves' Disease Relapse"],"prefix":"10.1177","volume":"26","author":[{"given":"Nyo Nyo Z.","family":"Tun","sequence":"first","affiliation":[{"name":"Royal Infirmary of Edinburgh","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoff","family":"Beckett","sequence":"additional","affiliation":[{"name":"Royal Infirmary of Edinburgh","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola N.","family":"Zammitt","sequence":"additional","affiliation":[{"name":"Royal Infirmary of Edinburgh","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark W. J.","family":"Strachan","sequence":"additional","affiliation":[{"name":"Royal Infirmary of Edinburgh","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan R.","family":"Seckl","sequence":"additional","affiliation":[{"name":"Royal Infirmary of Edinburgh","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fraser W.","family":"Gibb","sequence":"additional","affiliation":[{"name":"Royal Infirmary of Edinburgh","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2016,8,1]]},"reference":[{"key":"e_1_3_2_2_2","first-page":"593","article-title":"Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists","volume":"21","author":"Bahn RS","year":"2012","unstructured":"Bahn RS, , Burch HB, , Cooper DS, , Garber JR, , Greenlee MC, , Klein I, , Laurberg P, , McDougall IR, , Montori VM, , Rivkees SA, , Ross DS, , Sosa JA, , Stan MN. 2012. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Thyroid, 21:593\u2013646.","journal-title":"Thyroid"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF03346433"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-107-4-510"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.1997.7.369"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.K05-121"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF03343979"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.85.3.6430"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.K06-069"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-4309"},{"key":"e_1_3_2_11_2","first-page":"CD003420","article-title":"Antithyroid drug regimen for treating Graves' hyperthyroidism","author":"Abraham P","year":"2010","unstructured":"Abraham P, , Avenell A, , McGeoch SC, , Clark LF, , Bevan JS. 2010. Antithyroid drug regimen for treating Graves' hyperthyroidism. Cochrane Database Syst Rev. CD003420.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1258\/acb.2011.011013"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2008.11.025"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-3459"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1077051"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-2897"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1530\/eje.0.1460173"},{"key":"e_1_3_2_18_2","first-page":"98","article-title":"Meta-analysis evaluation of the impact of thyrotropin receptor antibodies on long term remission after medical therapy of Graves' disease","volume":"78","author":"Feldt-Rasmussen U","year":"1994","unstructured":"Feldt-Rasmussen U, , Schleusener H, , Carayon P. 1994. Meta-analysis evaluation of the impact of thyrotropin receptor antibodies on long term remission after medical therapy of Graves' disease. 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