The Early Changes in Thyroid-Stimulating Immunoglobulin Bioassay over Anti-Thyroid Drug Treatment Could Predict Prognosis of Graves’ Disease

Author:

Yu JinORCID,Baek Han-SangORCID,Jeong Chaiho,Jo Kwanhoon,Lee Jeongmin,Ha Jeonghoon,Kim Min Hee,Lee Jungmin,Lim Dong-JunORCID

Abstract

Background: To determine whether baseline thyroid-stimulating immunoglobulin (TSI) bioassay or its early response upon treatment with an anti-thyroid drug (ATD) can predict prognosis of Graves’ disease (GD) in real-world practice.Methods: This retrospective study enrolled GD patients who had previous ATD treatment with TSI bioassay checked at baseline and at follow-up from April 2010 to November 2019 in one referral hospital. The study population were divided into two groups: patients who experienced relapse or continued ATD (relapse/persistence), and patients who experienced no relapse after ATD discontinuation (remission). The slope and area under the curve at 1st year (AUC<sub>1yr</sub>) of thyroid-stimulating hormone receptor antibodies including TSI bioassay and thyrotropin-binding inhibitory immunoglobulin (TBII) were calculated as differences between baseline and second values divided by time duration (year).Results: Among enrolled 156 study subjects, 74 (47.4%) had relapse/persistence. Baseline TSI bioassay values did not show significant differences between the two groups. However, the relapse/persistence group showed less decremental TSI bioassay in response to ATD than the remission group (–84.7 [TSI slope, –198.2 to 8.2] vs. –120.1 [TSI slope, –204.4 to –45.9], P=0.026), whereas the TBII slope was not significantly different between the two groups. The relapse/persistence group showed higher AUC<sub>1yr</sub> of TSI bioassay and TBII in the 1st year during ATD treatment than the remission group (AUC<sub>1yr</sub> for TSI bioassay, P=0.0125; AUC<sub>1yr</sub> for TBII, <italic>P</italic>=0.001).Conclusion: Early changes in TSI bioassay can better predict prognosis of GD than TBII. Measurement of TSI bioassay at beginning and follow-up could help predict GD prognosis.

Publisher

Korean Endocrine Society

Subject

Endocrinology,Endocrinology, Diabetes and Metabolism

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