{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T22:14:23Z","timestamp":1784672063884,"version":"3.55.0"},"reference-count":17,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T00:00:00Z","timestamp":1751932800000},"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":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To establish the risk and time course of recurrent thyrotoxicosis following withdrawal of anti\u2010thyroid drugs (ATD) and risk factors for recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Single\u2010centre retrospective study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two hundred and ninety people with a first episode of Graves' thyrotoxicosis, who completed a course of ATD, were included. Clinical and biochemical parameters associated with recurrence risk were assessed over a 10\u2010year period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Recurrence occurred in 54% of individuals over a 10\u2010year period, with 73% occurring within 2 years. Younger age (41 years [33\u201351] vs. 47 [39\u201356], <jats:italic>p<\/jats:italic>\u2009=\u20090.011), higher TSH receptor antibody (TRAb) at diagnosis (8.8\u2009IU\/L [4.9\u221217.2] versus 6.0 [4.1\u22129.9], <jats:italic>p<\/jats:italic>\u2009=\u20090.002), higher TRAb at cessation of ATD (1.3 [&lt;0.9\u20132.3] vs. 1.0 [&lt;0.9\u20131.3], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), longer time to normalisation of TSH (6 months [3\u20139] vs. 4 [2\u20137], <jats:italic>p<\/jats:italic> 0.013) and longer time to normalisation of fT4 (2 months [1\u22123] vs. 1 [1\u22122], <jats:italic>p<\/jats:italic>\u2009=\u20090.001) were all associated with relapse within 10 years. Recurrence within 10 years occurred in 74% of individuals with TRAb\u2009&gt;\u200912\u2009IU\/L at diagnosis but only 44% of those with TRAb\u2009&lt;\u20095\u2009IU\/L at diagnosis (<jats:italic>p<\/jats:italic>\u2009=\u20090.001). TRAb (at diagnosis and cessation) and age were independently associated with relapse in multivariate analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Most recurrent thyrotoxicosis occurs within the first few years after ATD withdrawal. TRAb concentration, at diagnosis and cessation of ATD, is a useful predictor of recurrence risk and can be used to inform decisions on the optimal approach to primary therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.70003","type":"journal-article","created":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T13:14:26Z","timestamp":1752066866000},"page":"612-618","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Ten Year Outcome of Anti\u2010Thyroid Drug Treatment for First Episode Graves' Thyrotoxicosis: The Predictive Importance of TRAb"],"prefix":"10.1111","volume":"103","author":[{"given":"Nyo Nyo Z.","family":"Tun","sequence":"first","affiliation":[{"name":"Edinburgh Centre for Endocrinology &amp; Diabetes Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola N.","family":"Zammitt","sequence":"additional","affiliation":[{"name":"Edinburgh Centre for Endocrinology &amp; Diabetes Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark W. J.","family":"Strachan","sequence":"additional","affiliation":[{"name":"Edinburgh Centre for Endocrinology &amp; Diabetes Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan R.","family":"Seckl","sequence":"additional","affiliation":[{"name":"Edinburgh Centre for Endocrinology &amp; Diabetes Edinburgh UK"},{"name":"University\/BHF Centre for Cardiovascular Science University of Edinburgh Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5576-6463","authenticated-orcid":false,"given":"Fraser W.","family":"Gibb","sequence":"additional","affiliation":[{"name":"Edinburgh Centre for Endocrinology &amp; Diabetes Edinburgh UK"},{"name":"University\/BHF Centre for Cardiovascular Science University of Edinburgh Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2016.0229"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2012.07.003"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2016.0017"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.13873"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.85.3.6430"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-16-0725"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1258\/acb.2011.011013"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2008.11.025"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(19)30059-2"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-3459"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2009-2495"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-3644"},{"key":"e_1_2_8_14_1","unstructured":"Recommendations | Thyroid Disease: Assessment and Management | Guidance | NICE. November 20 2019. Accessed October 1 2024 https:\/\/www.nice.org.uk\/guidance\/ng145\/chapter\/Recommendations#managing-thyrotoxicosis."},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-20-1490"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.14721"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03346433"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2007.02933.x"}],"container-title":["Clinical Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cen.70003","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T10:02:32Z","timestamp":1757152952000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cen.70003"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,8]]},"references-count":17,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1111\/cen.70003"],"URL":"https:\/\/doi.org\/10.1111\/cen.70003","archive":["Portico"],"relation":{},"ISSN":["0300-0664","1365-2265"],"issn-type":[{"value":"0300-0664","type":"print"},{"value":"1365-2265","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,8]]},"assertion":[{"value":"2025-03-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}