2021 Asia-Pacific Graves’ Disease Consortium Survey of Clinical Practice Patterns in the Management of Graves’ Disease

Parameswaran R.; de Jong M.C.; Kit J.L.W.; Sek K.; Nam T.Q.; Thang T.V.; Khue N.T.; Aye T.T.; Tun P.M.; Cole T.; Miller J.A.; Villa M.; Khiewvan B.; Sirinvaravong S.; Sin Y.L.; Muhammad R.; Jap T.S.; Agrawal A.; Rajput R.; Fernando R.; Sumanatilleke M.; Suastika K.; Shong Y.K.; Lang B.; Bartalena L.; Yang S.P.

2021 Asia-Pacific Graves’ Disease Consortium Survey of Clinical Practice Patterns in the Management of Graves’ Disease

Issued Date

2023-01-01

Resource Type

Article

ISSN

1355008X

eISSN

15590100

DOI

10.1007/s12020-022-03193-7

Scopus ID

2-s2.0-85138512133

Pubmed ID

36129592

Journal Title

Endocrine

Volume

79

Issue

1

Start Page

135

End Page

142

Rights Holder(s)

SCOPUS

Bibliographic Citation

Endocrine Vol.79 No.1 (2023) , 135-142

Suggested Citation

Parameswaran R., de Jong M.C., Kit J.L.W., Sek K., Nam T.Q., Thang T.V., Khue N.T., Aye T.T., Tun P.M., Cole T., Miller J.A., Villa M., Khiewvan B., Sirinvaravong S., Sin Y.L., Muhammad R., Jap T.S., Agrawal A., Rajput R., Fernando R., Sumanatilleke M., Suastika K., Shong Y.K., Lang B., Bartalena L., Yang S.P., de Jong M.C. 2021 Asia-Pacific Graves’ Disease Consortium Survey of Clinical Practice Patterns in the Management of Graves’ Disease. Endocrine Vol.79 No.1 (2023) , 135-142. 142. doi:10.1007/s12020-022-03193-7 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/82342

Title

2021 Asia-Pacific Graves’ Disease Consortium Survey of Clinical Practice Patterns in the Management of Graves’ Disease

Other Contributor(s)

Mahidol University

Abstract

Aim: Although Graves’ disease (GD) is common in endocrine practices worldwide, global differences in diagnosis and management remain. We sought to assess the current practices for GD in countries across Asia and the Pacific (APAC), and to compare these with previously published surveys from North America and Europe. Methods: A web-based survey on GD management was conducted on practicing clinicians. Responses from 542 clinicians were received and subsequently analysed and compared to outcomes from similar surveys from other regions. Results: A total of 542 respondents participated in the survey, 515 (95%) of whom completed all sections. Of these, 86% were medical specialists, 11% surgeons, and 3% nuclear medicine physicians. In addition to serum thyroid-stimulating hormone (TSH) and free thyroxine assays, most respondents would request TSH-receptor autoantibody (TRAb) measurement (68%) during initial work-up. Thyroid ultrasound is requested by about half of respondents (53%), while the use of nuclear medicine scans is limited. The preferred first-line treatment is anti-thyroid drug (ATD) therapy (79%) with methimazole (MMI) or carbimazole (CBZ), followed by radioiodine (RAI; 19%) and surgery (2%). In case of surgery, one-third of respondents would opt for a subtotal rather than a total thyroidectomy. In case of mild Graves orbitopathy (GO), ATDs (67%) remains the preferred treatment, but a larger proportion of clinicians prefer surgery (20%). For a patient with intention to conceive, the preferred treatment pattern remained unchanged, although propylthiouracil (PTU) became the preferred ATD-agent during the first trimester. In comparison to European and American practices, marked differences were noted in the relatively infrequent usage of nuclear medicine scans and the overall higher use of a ATDs and β-blockers and adjunctive ATD-treatment during RAI in the APAC-group. Conclusion: Although regional differences regarding the diagnosis and management of GD are apparent in this first pan-Asia-Pacific survey, this study reveals the overall approach to the management of this disease in Asia-Pacific generally tends to fall between the trends appreciated in the American and European cohorts.

Keyword(s)

Biochemistry, Genetics and Molecular Biology

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/82342

Collections

Scopus 2023

Full item page

Send Feedback