{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T04:50:07Z","timestamp":1783486207798,"version":"3.55.0"},"reference-count":14,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,5,19]],"date-time":"2014-05-19T00:00:00Z","timestamp":1400457600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Peninsula Clahrc (Partly funded to support data collection)","award":["None"],"award-info":[{"award-number":["None"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2014,10]]},"abstract":"Summary<\/jats:title>Context<\/jats:title>Two widely used antithyroid drug (ATD<\/jats:styled-content>) regimes for Graves\u2019 disease (GD<\/jats:styled-content>) include the \u2018block & replace\u2019 (B&R) regime (a fixed high\u2010dose of ATD<\/jats:styled-content> combined with levothyroxine) and the \u2018titration\u2019 regime (a titrating dose of ATD<\/jats:styled-content>). Anecdotally, it is believed that B&R is less prone to fluctuating thyroid function.<\/jats:p><\/jats:sec>Objective<\/jats:title>To study whether, in routine clinical practice, the B&R regime, compared with the titration regime, is associated with more stable thyroid function.<\/jats:p><\/jats:sec>Methods<\/jats:title>We retrospectively analysed case\u2010records for 450 patients treated with ATD<\/jats:styled-content>s for GD<\/jats:styled-content> at a secondary care hospital. Exclusion criteria included treatment with ATD<\/jats:styled-content>s for <6\u00a0months, thyrotoxicosis due to other causes, treatment with radioiodine or thyroidectomy and pregnancy.<\/jats:p><\/jats:sec>Results<\/jats:title>Two hundred and twenty three patients were treated with the B&R regime (\u2018B&R group\u2019), 149 with the titration regime (\u2018titration group\u2019) and 78 with both regimes. The number of thyroid function tests (TFT<\/jats:styled-content>s) performed per year (mean(SD<\/jats:styled-content>): 3\u00b72(1\u00b72) vs<\/jats:italic> 3\u00b74(1\u00b75); adjusted mean difference\u00a0=\u00a0\u22120\u00b74; 95% CI<\/jats:styled-content>: \u22120\u00b77 to \u22120\u00b71; and P<\/jats:italic>\u00a0=\u00a00\u00b7008) and the number of hospital clinic visits per year (mean (SD<\/jats:styled-content>): 2\u00b79 (1\u00b70) vs<\/jats:italic> 3\u00b72 (1\u00b73); adjusted mean difference\u00a0=\u00a0\u22120\u00b74; 95% CI<\/jats:styled-content>: \u22120\u00b77 to \u22120\u00b72; and P<\/jats:italic>\u00a0=\u00a00\u00b7002) were lower in the B&R group than the titration group. The number of abnormal TFT<\/jats:styled-content> results per year was similar in the two groups (mean(SD<\/jats:styled-content>): 1\u00b78(1\u00b73) vs<\/jats:italic> 1\u00b78(1\u00b74); adjusted mean difference\u00a0=\u00a00\u00b705; 95%CI<\/jats:styled-content>: \u22120\u00b73 to 0\u00b74; and P<\/jats:italic>\u00a0=\u00a00\u00b774).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>In this retrospective study, there was little evidence that patients under B&R have more stable thyroid function. Further data from prospective studies, however, are needed to confirm this finding.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.12478","type":"journal-article","created":{"date-parts":[[2014,5,6]],"date-time":"2014-05-06T11:03:00Z","timestamp":1399374180000},"page":"610-613","source":"Crossref","is-referenced-by-count":28,"title":["Block & replace regime versus titration regime of antithyroid drugs for the treatment of Graves\u2019 disease: a retrospective observational study"],"prefix":"10.1111","volume":"81","author":[{"given":"Bijay","family":"Vaidya","sequence":"first","affiliation":[{"name":"Department of Endocrinology Royal Devon & Exeter Hospital Exeter UK"},{"name":"NIHR CLAHRC South West Peninsula (PenCLAHRC) University of Exeter Medical School Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ailsa","family":"Wright","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Royal Devon & Exeter Hospital Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Shuttleworth","sequence":"additional","affiliation":[{"name":"NIHR CLAHRC South West Peninsula (PenCLAHRC) University of Exeter Medical School Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mollie","family":"Donohoe","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Royal Devon & Exeter Hospital Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roderick","family":"Warren","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Royal Devon & Exeter Hospital Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia","family":"Brooke","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Royal Devon & Exeter Hospital Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian A.","family":"Gericke","sequence":"additional","affiliation":[{"name":"The Wesley Research Institute Brisbane Australia"},{"name":"University of Queensland Schools of Medicine & Population Health and Queensland Brain Institute Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Obioha C","family":"Ukoumunne","sequence":"additional","affiliation":[{"name":"NIHR CLAHRC South West Peninsula (PenCLAHRC) University of Exeter Medical School Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,5,19]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra042972"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-2802"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60782-4"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.4158\/EP.17.3.456"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2007.03097.x"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1530\/eje.1.02169"},{"issue":"1","key":"e_1_2_7_8_1","first-page":"CD003420","article-title":"Antithyroid drug regimen for treating Graves\u2019 hyperthyroidism","author":"Abraham P.","year":"2010","journal-title":"Cochrane Database Systematic 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