Graves' Disease Clinical Trial
Official title:
Prevention Relapse of Graves' Disease by Treatment With Intrathyroid Injection of Dexamethasone
Antithyroid drugs are widely used in treatment of Graves' disease (GD), but after therapy withdrawal, relapse rate is very high. The aim this trail is to evaluate the effects of intrathyroid injection of dexamethasone combined with antithyroid drugs on patients with newly diagnosed GD.
The morbility of GD is nearly 0.5% and the underlying cause of 50 to 80% of cases of
hyperthyroidism.Recently,anti-thyroid drugs are still the main therapy for
Graves'hyperthyroidism in a lot of districts, but the relapse rate is very high (51~68%)
after withdrawal of anti-thyroid treatment.In order to reduce the relapse rate, some studies
tried to prescribe replacement thyroxine, either with the anti-thyroid drug treatment, or
after this was completed, but there is no clear evidence in favour of giving thyroid hormone
supplementation following the initial treatment of Graves' thyrotoxicosis with anti-thyroid
medication. Therefore, the optimal medical therapy for Graves' hyperthyroidism remains a
subject of debate.
It is well known that glucocorticoids have anti-inflammatory, immunomodulation and
immunosuppression effects and they has long been used to treat GO, and is one of the most
effective medicine ,it can decrease some cytokines and reduce inflammatory status ,and
improve some thyroid specific antibody, like as thyrotropin receptor antibodies (TRAb),
antithyroperoxidase antibodies (TPOAb) and antithyroglobulin antibodies (TGAb).These studies
suggested that glucocorticoids might affect autoimmune process and have some benefit effects
on GD. Moreover glucocorticoids have been used to treat GD in several early reports, in
which serum free triiodothyronine (FT3) and thyroxine (FT4) or total T3(TT3) and TT4 levels
decreased after 8 days or three weeks treatment with glucocorticoids . But in those studies,
the number of selected patients is small, and the duration of the therapy is relatively
short, so that might not confirm the effects of glucocorticoids on GD.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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