{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T18:05:45Z","timestamp":1791050745632,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,8,21]],"date-time":"2014-08-21T00:00:00Z","timestamp":1408579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001868","name":"Taiwan National Science Council","doi-asserted-by":"crossref","award":["NSC100-2320-B-016-002"],"award-info":[{"award-number":["NSC100-2320-B-016-002"]}],"id":[{"id":"10.13039\/501100001868","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2014,9]]},"abstract":"Aims<\/jats:title>The evidence of hepatotoxicity of antithyroid drugs (ATDs<\/jats:styled-content>) is limited to case reports or spontaneous reporting. This study aimed to quantify the incidence and comparative risks of hepatotoxicity for methimazole (MMI<\/jats:styled-content>)\/carbimazole (CBM<\/jats:styled-content>) vs.<\/jats:italic> propylthiouracil (PTU<\/jats:styled-content>) in a population\u2010based manner.<\/jats:p><\/jats:sec>Methods<\/jats:title>We conducted a cohort study of hyperthyroidism patients initially receiving MMI<\/jats:styled-content>\/CBM<\/jats:styled-content> or PTU<\/jats:styled-content> between 1 January 2004 and 31 December 2008 using the T<\/jats:styled-content>aiwan National Health Insurance Research Database. The examined hepatotoxicity consisted of cholestasis, non\u2010infectious hepatitis, acute liver failure and liver transplant, with the incidences and relative risks being quantified by Poisson exact methods and Cox proportional hazard models, respectively.<\/jats:p><\/jats:sec>Results<\/jats:title>The study cohort comprised 71\u2009379 ATD<\/jats:styled-content> initiators, with a median follow\u2010up of 196 days. MMI<\/jats:styled-content>\/CBM<\/jats:styled-content>\u2005vs.<\/jats:italic>\u2005PTU<\/jats:styled-content> users had a higher hepatitis incidence rate (3.17\/1000 vs.<\/jats:italic> 1.19\/1000 person\u2010years) but a lower incidence of acute liver failure (0.32\/1000 vs.<\/jats:italic> 0.68\/1000 person\u2010years). The relative risk analysis indicated that any use of MMI<\/jats:styled-content>\/CBM<\/jats:styled-content> was associated with a 2.89\u2010fold (95% CI<\/jats:styled-content> 1.81, 4.60) increased hepatitis risk compared with PTU<\/jats:styled-content>, with the risk increasing to 5.08\u2010fold for high dose MMI<\/jats:styled-content>\/CBM<\/jats:styled-content> (95% CI<\/jats:styled-content> 3.15, 8.18). However, any MMI<\/jats:styled-content>\/CBM<\/jats:styled-content> use vs.<\/jats:italic>\u2005PTU<\/jats:styled-content> was not related to an increased risk of cholestasis (adjusted hazard ratio [HR<\/jats:styled-content>] 1.14, 95% CI<\/jats:styled-content> 0.40, 3.72) or acute liver failure (adjusted HR<\/jats:styled-content> 0.54, 95% CI<\/jats:styled-content> 0.24, 1.22).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>MMI<\/jats:styled-content>\/CBM<\/jats:styled-content> and PTU<\/jats:styled-content> exert dissimilar incidence rates of hepatotoxicity. Compared to PTU<\/jats:styled-content>, MMI<\/jats:styled-content>\/CBM<\/jats:styled-content> are associated in a dose\u2010dependent manner with an increased risk for hepatitis while the risks are similar for acute liver failure and cholestasis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bcp.12336","type":"journal-article","created":{"date-parts":[[2014,2,12]],"date-time":"2014-02-12T12:46:08Z","timestamp":1392209168000},"page":"619-629","source":"Crossref","is-referenced-by-count":100,"title":["Antithyroid drug\u2010related hepatotoxicity in hyperthyroidism patients: a population\u2010based cohort study"],"prefix":"10.1111","volume":"78","author":[{"given":"Meng\u2010Ting","family":"Wang","sequence":"first","affiliation":[{"name":"School of Pharmacy National Defense Medical Center Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan\u2010Ju","family":"Lee","sequence":"additional","affiliation":[{"name":"School of Pharmacy National Defense Medical Center Taipei Taiwan"},{"name":"College of Pharmacy University of Illinois at Chicago Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tien\u2010Yu","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Department of Internal Medicine Tri\u2010Service General Hospital National Defense Medical Center Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Che\u2010Li","family":"Chu","sequence":"additional","affiliation":[{"name":"School of Pharmacy National Defense Medical Center Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang\u2010Hsun","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism Department of Internal Medicine Tri\u2010Service General Hospital National Defense Medical Center Taipei 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