{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T23:31:09Z","timestamp":1777419069710,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2007,6,1]],"date-time":"2007-06-01T00:00:00Z","timestamp":1180656000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2007,6]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>To evaluate the evidence supporting the use of propylthiouracil (PTU) versus methimazole for the treatment of Graves' disease during pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DATA SOURCES:<\/jats:title>\n                    <jats:p>An English-language literature search was conducted using MEDLINE (1966\u2013March 2007). Identified articles were then reviewed for additional sources. Search terms included hyperthyroidism, Graves' disease, pregnancy, propylthiouracil, and methimazole.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>STUDY SELECTION AND DATA EXTRACTION:<\/jats:title>\n                    <jats:p>All clinical trials and case reports that were published in English and reported either subjective or objective outcomes were reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DATA SYNTHESIS:<\/jats:title>\n                    <jats:p>Rationale supporting the use of PTU over methimazole in treatment of Graves' disease during pregnancy is limited. Theories suggesting that PTU has less placental transfer to the fetus than methimazole are not supported by current literature. Studies demonstrating a causal relationship between methimazole use during pregnancy and congenital anomalies and\/or fetal hypothyroidism do not exist.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>The selection of PTU versus methimazole for the treatment of Graves' disease during pregnancy should not be based solely on the following assumptions: that PTU crosses the placenta less than methimazole, that PTU leads to less fetal hypothyroidism, or that exposure to methimazole during pregnancy leads to decreased intellectual function in children. However, due to a possible association between the use of methimazole during pregnancy and fetal anomalies such as aplasia cutis, esophageal atresia, and choanal atresia, methimazole may be a less desirable first-line treatment for Graves' disease in pregnancy than PTU. Therefore, in the absence of a compelling indication for the use of methimazole, PTU should still be considered as the first-line agent in the treatment of Graves' disease during pregnancy. Methimazole should be considered a viable second choice if the patient is intolerant to PTU, has an allergic reaction to PTU, or fails to become euthyroid while receiving PTU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONES:<\/jats:title>\n                    <jats:p>La selecci\u00f3n de PTU versus metimazole en el tratamiento de enfermedad de Graves durante el embarazo no debe ser basada en la siguiente informaci\u00f3n: 1que PTU cruza la placenta a un menor grado que metimazole, que PTU se asocia con menos hipotiroidismo fetal, \u00f3 que la exposici\u00f3n a metimazole durante el embarazo lleva a una disminuci\u00f3n en la funci\u00f3n intelectual en ni\u00f1os. Sin embargo, debido a una posible asociaci\u00f3n entre el uso de metimazole durante el embarazo y anormalidades fetales tales como aplasia cutis, atresia esofageal y atresia choanal, metimazole podr\u00eda ser una alternativa de primera l\u00ednea menos deseable para el tratamiento de enfermedad de Graves durante el embarazo que PTU. Por lo tanto, en la ausencia de indicaci\u00f3n contundente para el uso de metimazole, PTU debe considerarse el agente de primera l\u00ednea en el tratamiento de enfermedad de Graves durante el embarazo. Sin embargo, metimazole puede considerarse un agente alterno si el paciente no tolera el PTU, tiene reacci\u00f3n al\u00e9rgica a PTU o falla en convertir a eutirodeo con PTU. R\u00c9SUM\u00c9: Il existe peu de justification \u00e0 l'utilisation du PTU plut\u00f4t que du methimazole. Certaines th\u00e9ories sugg\u00e9rant que le PTU traverse moins la barri\u00e8re placentaire ne sont pas, \u00e0 l'heure actuelle, support\u00e9es par des \u00e9vidences. Les \u00e9tudes d\u00e9montrant une relation de cause \u00e0 effet entre le methimazole et des anomalies cong\u00e9nitales et\/ou de l'hypothyro\u00efdisme chez le f\u00e9tus n'existent pas.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1345\/aph.1h535","type":"journal-article","created":{"date-parts":[[2007,5,15]],"date-time":"2007-05-15T20:55:54Z","timestamp":1179262554000},"page":"1018-1022","source":"Crossref","is-referenced-by-count":39,"title":["Propylthiouracil Versus Methimazole in Treatment of Graves' Disease During Pregnancy"],"prefix":"10.1177","volume":"41","author":[{"given":"Jeanne M","family":"Chattaway","sequence":"first","affiliation":[{"name":"Jeanne M Chattaway PharmD, Managed Care Pharmacy Practice Resident, Department of Clinical Pharmacy, College of Pharmacy, Ferris State University, Big Rapids, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa B","family":"Klepser","sequence":"additional","affiliation":[{"name":"Teresa B Klepser PharmD, Associate Professor, Department of Clinical Pharmacy, College of Pharmacy, Ferris State University"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2007,6,1]]},"reference":[{"key":"bibr1-aph.1H535","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200010263431707"},{"key":"bibr2-aph.1H535","first-page":"1369","volume-title":"Pharmacotherapy: A pathophysiological approach","author":"Talbert RL","year":"2005","edition":"6"},{"key":"bibr3-aph.1H535","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra042972"},{"key":"bibr4-aph.1H535","doi-asserted-by":"publisher","DOI":"10.1055\/s-2003-42719"},{"key":"bibr5-aph.1H535","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2004.03.005"},{"key":"bibr6-aph.1H535","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8529(05)70303-0"},{"key":"bibr7-aph.1H535","doi-asserted-by":"publisher","DOI":"10.1016\/S1096-6374(03)00055-8"},{"key":"bibr8-aph.1H535","volume-title":"Diagnosis and treatment of hyperthyroidism during pregnancy","author":"Ross DS","year":"2006"},{"key":"bibr9-aph.1H535","volume-title":"Overview of thyroid disease in pregnancy","author":"Ross DS","year":"2006"},{"key":"bibr10-aph.1H535","doi-asserted-by":"publisher","DOI":"10.1080\/01443619866219"},{"key":"bibr11-aph.1H535","doi-asserted-by":"publisher","DOI":"10.1089\/thy.1999.9.647"},{"key":"bibr12-aph.1H535","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-200023030-00005"},{"key":"bibr13-aph.1H535","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.86.6.7573"},{"key":"bibr14-aph.1H535","first-page":"70","volume":"40","author":"Dwarakanath CS","year":"1999","journal-title":"Singapore Med J"},{"key":"bibr15-aph.1H535","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.10098"},{"key":"bibr16-aph.1H535","doi-asserted-by":"publisher","DOI":"10.1089\/thy.1992.2.219"},{"key":"bibr17-aph.1H535","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-106-1-60"},{"key":"bibr18-aph.1H535","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.87.2.8126"},{"key":"bibr19-aph.1H535","doi-asserted-by":"publisher","DOI":"10.1002\/tera.1072"},{"key":"bibr20-aph.1H535","unstructured":"20. 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