{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:48:04Z","timestamp":1787168884319,"version":"build-2736575974"},"reference-count":51,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Recent years have seen changes and uncertainties in evidence and guideline recommendations in Graves' disease treatment. To understand the impact of these developments on current practice, we undertook a survey of Graves' disease management in the United Kingdom and compared this to other national and international surveys.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Members of the British Thyroid Association, the UK Society for Endocrinology and regional endocrinology networks, were invited by e\u2010mail to complete a 15\u2010min online survey (October 2022 to March 2023).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Out of 158 eligible respondents, 99% were endocrinologists. For a 40\u2010year\u2010old female with a first presentation of Graves' hyperthyroidism, TSH\u2010receptor antibodies (TRAb) were requested at diagnosis and at follow\u2010up by 95% and 76%, respectively. Isotope scans and ultrasound were rarely requested (&lt; 5%). Majority (95%) would treat with antithyroid drugs (ATD), predominantly Carbimazole (CMZ), while radioactive iodine (RAI) was preferred for recurrent disease (81%). Common reasons for avoiding RAI were thyroid eye disease, pregnancy intention, or contact with young children whereas biochemical severity, goitre, or male sex did not influence decision to use RAI. Propylthiouracil (PTU) was preferred in preconception and early pregnancy, but after the first\u2010trimester, 50% would continue PTU while 50% switch back to CMZ.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The survey confirms a growing application of TRAbs, both for diagnostic and prognostic purposes. ATDs remain the preferred first\u2010line therapy for Graves' disease, which is consistent with global trends but contrary to National Institute of Health and Care Excellence (NICE) guidance. Further studies are required to explore the clinical and pragmatic determinants of current treatment approaches.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cen.15266","type":"journal-article","created":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T06:04:19Z","timestamp":1746684259000},"page":"376-384","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["British Thyroid Association Survey of Graves' Disease Management in the UK"],"prefix":"10.1111","volume":"103","author":[{"given":"Michael","family":"Atkinson","sequence":"first","affiliation":[{"name":"Swansea Bay University Health Board Swansea UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Medha","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Aneurin Bevan University Health Board Newport UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0041-7813","authenticated-orcid":false,"given":"Koteshwara","family":"Muralidhara","sequence":"additional","affiliation":[{"name":"Kingston Hospital NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prakash","family":"Abraham","sequence":"additional","affiliation":[{"name":"Endocrinology, Aberdeen Royal Infirmary Aberdeen UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2223-0494","authenticated-orcid":false,"given":"Bijay","family":"Vaidya","sequence":"additional","affiliation":[{"name":"Royal Devon &amp; Exeter Hospital University of Exeter Medical School Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2221-992X","authenticated-orcid":false,"given":"Onyebuchi E.","family":"Okosieme","sequence":"additional","affiliation":[{"name":"Cwm Taf Morgannwg Health Board Merthyr Tydfil UK"},{"name":"Thyroid Research Group, Systems Immunity Research Institute Cardiff University School of Medicine Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,8]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)02016-0"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2018.18"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.4158\/EP-2019-0363"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjophth-2023-001515"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(23)00005-0"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.13731"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2005.15.1279"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2022.0251"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-11-0299"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000490384"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2016.0229"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(19)30059-2"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgad538"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2007.03097.x"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/postgradmedj-2016-134187"},{"key":"e_1_2_6_17_1","volume-title":"Thyroid Disease Guidelines","author":"NICE","year":"2019"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13044-020-00077-8"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-16-0527"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2019.0981"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgae222"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.14721"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-20-0445"},{"issue":"1436","key":"e_1_2_6_24_1","first-page":"10","article-title":"The Management of Graves' Disease in New Zealand 2014","volume":"129","author":"Cox S. 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