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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EInitiating low-dose levothyroxine at 4 weeks after radioactive iodine therapy for Graves disease appears safe and did not increase the risk of hyperthyroidism in this interim safety analysis of 20 patients.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EGraves disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Elevothyroxine\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eradioactive iodine\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ehypothyroidism\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ENCT01950260\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eendocrinology, diabetes \u0026amp; metabolism clinical trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ethyroid disorders\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \n         \u003Cp id=\u0022p-2\u0022\u003ESpyridoula Maraka, MD, Mayo Clinic, Rochester, Minnesota, USA, reported on results from an interim safety analysis, which found that initiating low-dose levothyroxine at 4 weeks after patients received radioactive iodine (RAI) for Graves\u2019 disease (GD) appears safe and shows no increased incidence of hyperthyroidism.\u003C\/p\u003E\n         \u003Cp id=\u0022p-3\u0022\u003EMost patients with GD are treated with RAI and reevaluated 2 to 3 months later; the majority are hypothyroid by that time, and some have related troublesome symptoms and possible development or worsening of Graves\u2019 orbitopathy.\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003EThis randomized double-blind controlled trial [\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT01950260\u0026amp;atom=%2Fspmdc%2F15%2F4%2F10.1.atom\u0022\u003ENCT01950260\u003C\/a\u003E] was designed to determine whether early treatment with levothyroxine after RAI therapy for GD would prevent overt hypothyroidism. This interim analysis for safety was performed after the first 17 patients were enrolled, with 11 patients receiving levothyroxine, 25 mg QD, and 6 receiving placebo in a single tablet at 4 weeks after RAI therapy. At 6 weeks after RAI therapy, the levothyroxine dose was increased to 50 mg QD and the placebo to 2 tablets per day. At 8 weeks after RAI therapy, the treating physician evaluated the patients and treated them as clinically indicated for reaching euthyroidism.\u003C\/p\u003E\n         \u003Cp id=\u0022p-5\u0022\u003EExclusion criteria included a clinical manifestation of Graves\u2019 orbitopathy, recent history of arrhythmias or any history of ventricular arrhythmias, preexistent cardiomyopathy, malnutrition, or psychiatric history. Researchers also considered the likelihood of whether patients would return for follow-up visits.\u003C\/p\u003E\n         \u003Cp id=\u0022p-6\u0022\u003EThe enrolled patients were a median of 52.7 years of age in the levothyroxine arm and 55.3 years in the placebo arm. The levothyroxine arm was 72.7% women, and the placebo arm was 66.7% women. Median thyroid size was 30 g in both arms. Median free thyroxine was 2.7 ng\/dL in the levothyroxine arm and 1.9 ng\/dL in the placebo arm.\u003C\/p\u003E\n         \u003Cp id=\u0022p-7\u0022\u003EPatient history was taken at weeks 0, 8, and 24. Physical examinations and goiter size measurements occurred at weeks 0 and 8. Quality-of-life questionnaires were used at weeks 4, 6, 8, and 24.\u003C\/p\u003E\n         \u003Cp id=\u0022p-8\u0022\u003EOnly 1 adverse event was reported: a patient in the levothyroxine arm had heart palpitations that led to the decision to discontinue the study drug. This patient had a history of chronic atrial fibrillation and discontinued beta-blocker therapy during the study.\u003C\/p\u003E\n         \u003Cp id=\u0022p-9\u0022\u003EAt 8 weeks, overt hypothyroidism occurred in 54.5% of patients who received levothyroxine and in 66.7% of patients who received the placebo (\u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E). The rate of hyperthyroidism was lower in the levothyroxine group (18.2%) than in the placebo group (33.3%).\u003C\/p\u003E\n         \u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/16521\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/16521\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16521\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n               \u003Cp id=\u0022p-10\u0022 class=\u0022first-child\u0022\u003EResults After 8 Weeks\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-13\u0022\u003EThe thyroid symptom questionnaire scores were similar between the levothyroxine and placebo groups. The health-related quality-of-life questionnaire found that the levothyroxine group was more symptomatic than the placebo group (median score, 46 vs 36).\u003C\/p\u003E\n         \u003Cp id=\u0022p-14\u0022\u003EInitiating low-dose levothyroxine at 4 weeks after RAI appears safe and does not increase the risk of hyperthyroidism. The data, though statistically insignificant, suggest that this strategy might prevent overt hypothyroidism. The research team plans to continue the trial to completion without modifying the protocol.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 SAGE Publications\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/15\/4\/10.1.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzlmo1\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzlmo1\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}