Prospective,Follow-Up Study Of Different Doses Of Methimazole In The Treatment Of Graves’ Disease

Objective: To compare the effect of different initial doses of methimazole on efficacy and security in the treatment of mild to moderate Graves disease.Methods: A total of 190 incipient Graves patients admitted to our hospital from June2014 to June 2017 were randomly divided into two groups: low-dose treatment group(methimazole 15 mg),high-dose treatment group(methimazole 30 mg)were given methimazole(Merck,Germany)15,30 mg / d,observed the application of different doses of methimazole in patients with Graves treatment efficiency and adverse reactions.Results: By studying 190 patients with newly diagnosed Graves’ disease,we found that(1)the median time to FT3,FT4 and TSH in low-dose group were 5.2,6.1 and 9 weeks,respectively,in high-dose group were 5.5,7.8 and 9.2 weeks,respectively,there was no significant difference between the two groups in the median of FT3,FT4 and TSH reached the normal time;(2)there was no significant difference in the average TRAb between the two groups during the study period;(3)the incidence of hypothyroxinemia was 24.7% in the low-dose group and 57.4% in the high-dose group.The difference was statistically significant(P<0.05);(4)the mean±standard deviation,median,minimum,and maximum tie of hypothyroxinemia in the low-dose group were 11.9±7.1,9.8,4,and 39.4weeks,respectively,and the mean±standard deviation,median,minimum,and maximum tie of hypothyroxinemia in the high-dose group were 12.2 ± 7.21,10.6,2.7,and 46.7weeks,respectively.There was no significant difference between the two groups in the occurrence time of hypothyroxinemia;(5)the incidence of liver dysfunction was 16.9% in low dose group and 29.3% in high dose group,with no significant difference;(6)the incidence of leukopenia,neutropenia and agranulocytosis in low-dose group were 2.5%,2.5%,0 respectively.The incidences of neutropenia,neutropenia and neutropenia in high-dose group were 4.2%,5.2%,2.1%,the difference was not statistically significant;(7)the incidence of rash in the low-dose group was 10.1%,and that in the high-dose group was 15.8%.there was no significant difference between the two groups;(8)he overall incidence of adverse reactions was 21.3% in low-dose group,and 34.6% in high-dose group,the overall incidence of adverse reactions in low-dose group was lower than that in high-dose group,the difference was statistically significant(P<0.05).Conclusion: Two different initial doses of MMI treatment of mild to moderate Graves disease no difference in efficacy,and although the low-dose group of leukopenia,liver damage and other adverse drug reactions incidence compared with high-dose group no significant difference,however,the incidence of adverse reactions in the low-dose group was lower than that in the high-dose group,small doses methimazole treatment for Graves disease should be vigorously promoted.