THE CONTEXT
Carbimazole and propylthiouracil are commonly used antithyroid drugs for restoring and maintaining a euthyroid state.
Treatment aim
•
Treatment maintains a euthyroid state for a prolonged period in the hope of permanent remission as production of TSH-RAb diminishes or ceases.
Limitation in toxic nodules
•
Antithyroid drugs cannot cure a toxic nodule because its overactive thyroid tissue is autonomous.
•
Hyperthyroidism is certain to recur when the drug is discontinued in this setting.
Advantages and treatment burden
•
Drug treatment avoids surgery and radioactive materials.
•
Treatment is prolonged, and the failure rate is at least 55%.
•
Duration may be tailored to severity: milder cases may receive 6 months of treatment and severe cases 2 years before therapy is stopped.