Recombinant human TSH increases the efficacy of a fixed activity of radioiodine for treatment of multinodular goitre

International Journal of Clinical Practice
E R CubasHans Graf

Abstract

High doses of (131)I are usually needed in the treatment of multinodular goitre (MNG) for effective thyroid volume (TV) reduction. Recombinant human thyroid-stimulating hormone (rhTSH) is an adjuvant to enhance (131)I uptake, allowing a decrease in radiation activity and enhancing (131)I efficacy. To evaluate whether rhTSH increases the efficacy of a fixed activity of (131)I for the treatment of MNG. Two-year, observational, placebo-controlled study. Patients received 0.1 mg rhTSH (A), 0.005 mg rhTSH (B) or placebo (C). A fixed activity of 1.11 GBq of (131)I was administered 24 h after rhTSH or placebo. A total of 28 outpatients (26 females and two males) with MNG. TSH, free T4, T3, thyroglobulin (Tg) and TV. Basal radioactive iodine uptake and TV values were comparable among all groups. After rhTSH or placebo, peak levels of TSH, free T4, T3 and Tg were higher in A than in B or in C (p < 0.05). Hyperthyroidism was observed in A (n = 2), B (n = 6) and C (n = 4). Thyroid enlargement was reported in A (n = 3) and B (n = 6). After 24 months, 10 patients developed hypothyroidism (four in A, three in B and three in C). TV reduction was similar between A and B (37.2 +/- 25.5% vs. 39.3 +/- 27.9%, p = 0.88), but different from the non-...Continue Reading

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Citations

Feb 27, 2010·European Journal of Nuclear Medicine and Molecular Imaging·Massimo Salvatori, Markus Luster
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