A 2013 European survey of clinical practice patterns in the management of Graves' disease.

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Citation: Clinical Endocrinology. 84(1):115-20, 2016 Jan.PMID: 25581877Institution: MedStar Washington Hospital CenterDepartment: Medicine/EndocrinologyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Graves Disease/di [Diagnosis] | *Graves Disease/dt [Drug Therapy] | *Practice Patterns, Physicians'/sn [Statistics & Numerical Data] | *Surveys and Questionnaires | Antithyroid Agents/tu [Therapeutic Use] | Autoantibodies/bl [Blood] | Autoantibodies/im [Immunology] | Europe | Female | Graves Disease/bl [Blood] | Humans | Methimazole/tu [Therapeutic Use] | North America | Pregnancy | Pregnancy Complications/bl [Blood] | Pregnancy Complications/di [Diagnosis] | Pregnancy Complications/dt [Drug Therapy] | Propylthiouracil/tu [Therapeutic Use] | Receptors, Thyrotropin/im [Immunology] | Thyrotropin/bl [Blood] | Thyroxine/bl [Blood]Year: 2016ISSN:
  • 0300-0664
Name of journal: Clinical endocrinologyAbstract: CONCLUSIONS: Significant changes in clinical practice patterns in Europe were noted compared to the previous European survey, as well as persisting differences in diagnosis and therapy between Europe and North America.Copyright © 2015 John Wiley & Sons Ltd.DESIGN: Members of the European Thyroid Association (ETA) were asked to participate in a survey on management of GD, using the same questionnaire of a recent American survey.OBJECTIVE: Management of Graves' disease (GD) in Europe was published in 1987. Aim of this survey was to provide an update on clinical practice in Europe, and to compare it with a 2011 American survey.RESULTS: A total of 147 ETA members participated. In addition to serum TSH and free T4 assays, most respondents would request TSH-receptor autoantibody (TRAb) measurement (85.6%) and thyroid ultrasound (70.6%) to confirm aetiology, while isotopic studies were selected by 37.7%. Antithyroid drug (ATD) therapy was the preferred first-line treatment (83.8%). Compared to the previous European survey, Europeans currently more frequently use TRAb measurement and thyroid ultrasound for diagnosis and evaluation, but first-line treatment remains ATDs in a similar percentage of respondents. Current clinical practice patterns differ from those in North America, where isotopic studies are more frequently used, and radioiodine (RAI) still is first-line treatment. When RAI treatment is selected in the presence of mild Graves' orbitopathy and/or associated risk factors for its occurrence/exacerbation, steroid prophylaxis is frequently used. The preferred ATD in pregnancy is propylthiouracil in the first trimester and methimazole in the second and third trimesters, similar to North America.All authors: Bartalena L, Burch HB, Burman KD, Kahaly GJFiscal year: 2016Digital Object Identifier: Date added to catalog: 2017-03-06
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Journal Article MedStar Authors Catalog Article 25581877 Available 25581877

CONCLUSIONS: Significant changes in clinical practice patterns in Europe were noted compared to the previous European survey, as well as persisting differences in diagnosis and therapy between Europe and North America.Copyright © 2015 John Wiley & Sons Ltd.

DESIGN: Members of the European Thyroid Association (ETA) were asked to participate in a survey on management of GD, using the same questionnaire of a recent American survey.

OBJECTIVE: Management of Graves' disease (GD) in Europe was published in 1987. Aim of this survey was to provide an update on clinical practice in Europe, and to compare it with a 2011 American survey.

RESULTS: A total of 147 ETA members participated. In addition to serum TSH and free T4 assays, most respondents would request TSH-receptor autoantibody (TRAb) measurement (85.6%) and thyroid ultrasound (70.6%) to confirm aetiology, while isotopic studies were selected by 37.7%. Antithyroid drug (ATD) therapy was the preferred first-line treatment (83.8%). Compared to the previous European survey, Europeans currently more frequently use TRAb measurement and thyroid ultrasound for diagnosis and evaluation, but first-line treatment remains ATDs in a similar percentage of respondents. Current clinical practice patterns differ from those in North America, where isotopic studies are more frequently used, and radioiodine (RAI) still is first-line treatment. When RAI treatment is selected in the presence of mild Graves' orbitopathy and/or associated risk factors for its occurrence/exacerbation, steroid prophylaxis is frequently used. The preferred ATD in pregnancy is propylthiouracil in the first trimester and methimazole in the second and third trimesters, similar to North America.

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