Data from a recent study suggest a potential relevant decrease in the risk of relapse when immunosuppressants are added to standard treatment of Graves’ disease. Full study findings are published inThyroid

Study authors aimed to study the effects of immunosuppressants on the rate of relapse after a first episode of hyperthyroidism due to Graves’ disease. They searched PubMed, EMBASE and Cochran databases for (randomized)-controlled trials comparing immunosuppressants with a control group.  Data were pooled using a random-effects model. The primary endpoint was relapse of disease until follow-up; secondary endpoints included reduction of thyroid volume and decrease in TSH-receptor-antibody levels. 

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Seven trials with 862 participants were included for the analysis. A total of 113 relapses in 481 patients (23.5%) receiving immunosuppressants were reported vs. 225 relapses in 381 control patients (59.1%); risk ratio for recurrence 0.55 (95% CI: 0.41, 0.75). Similar effects were seen for both randomized trials and controlled trials, and for trials using corticosteroids and non-corticosteroids immunosuppressants. 

Significant reductions in thyroid volume (-10.72mL, 95% CI: -15.59, -5.85) and TSH-receptor-antibody levels (-17.01U/L, 95% CI: -33.31, -0.72) were seen with the use of immunosuppressants. Overall, current evidence points to a possible reduction in relapse risk with the addition of immunosuppressants to standard Graves’ disease treatment. Study authors added that larger, conclusive trials are necessary. 

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