{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T11:44:28Z","timestamp":1793965468112,"version":"4.8.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T00:00:00Z","timestamp":1743724800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Graves\u00b4 disease (GD) is the predominant cause of hyperthyroidism. Treatment options include antithyroid drugs (ATD), surgery, and radioactive iodine ablation (RI). Although thyroid peroxidase antibodies (anti-TPO) are prevalent in patients with GD, their role in driving relapse or hypothyroidism after treatment in patients with GD remains unclear. This study aimed to determine if patients with anti-TPO at GD diagnosis are more likely to relapse after ATD or RI treatment, and if patients with anti-TPO are at increased risk of developing hypothyroidism post-ATD treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was an observational, non-interventional retrospective registry study, which included 712 patients treated for GD at a single center in Sweden during 2002-2018.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After therapy with ATD, there was no difference in relapse rate between patients with (37.0%) or without (38.4%) anti-TPO at GD diagnosis. Age &amp;lt;40 years was a risk factor for relapse after ATD (p&amp;lt;0.0001). Presence of anti-TPO at diagnosis was associated with reduced relapse rate after RI (13.9% vs. 24.6%; p=0.049). Development of hypothyroidism after discontinuation of ATD did not correlate with anti-TPO status at diagnosis (with anti-TPO: 17.3%; without anti-TPO: 20.8%). Increased risk of hypothyroidism was seen with ATD treatment for &amp;gt;2 years, p&amp;lt;0.05.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Anti-TPO positivity at diagnosis of GD did not affect the relapse rate after ATD treatment but could be associated with a better long-term effect of RI. Anti-TPO did not increase the risk of hypothyroidism post-ATD therapy. Understanding risk factors of relapse or hypothyroidism can facilitate treatment choices and help physicians individualize management and follow-up strategies for patients with GD.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1517283","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T10:53:34Z","timestamp":1743764014000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Thyroid peroxidase antibodies and their role in predicting outcomes in Graves\u2019 disease treatment"],"prefix":"10.3389","volume":"16","author":[{"given":"Klara","family":"Gewert","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geriolda","family":"Topi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tereza","family":"Planck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Calissendorff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(16)00278-6","article-title":"Hyperthyroidism","volume":"388","author":"De Leo","year":"2016","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1510030","article-title":"Graves\u2019 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