Comparison of curative effect of 131I and antithyroid drugs in Graves' disease: a meta-analysis.

INTRODUCTION: Radioactive 131I is currently reported to be a potential effective intervention for Graves' disease treatment in China. Whether 131I treatment was associated with effective outcome or reduced risk of side effects, recurrence rate remained unknown.

EVIDENCE ACQUISITION: Eligible studies were selected from Chinese VIP, Wangfang, CNKI databases using the keywords "Iodine" and "Graves' disease". Finally, 13 clinical trials met the inclusion criterion and were included this meta-analysis.

EVIDENCE SYNTHESIS: Our meta-analysis included 1355 patients diagnosed of Graves' disease with regular anti-thyroid drugs oral administration and 1320 patients with 131I therapy. The results showed that there was significant symptom improvement with radioactive iodine intervention (Odd Ratio [OR]=4.50, 95% CI: 3.55-5.71, P<0.01). Three studies mentioned side effects, 6 mentioned recurrence rate and another 6 mentioned hypothyroidism. The ORs and 95% CIs for these subgroups were 0.12 (0.06, 0.21), 0.08 (0.05, 0.13) and 2.27 (1.77, 2.92) respectively. It means a significant reduction of side effects and recurrence rate but increased hypothyroidism after 131I intervention in Graves' disease.

CONCLUSIONS: Treatment with 131I was associated with better clinical outcome; it reduced side effects and reccurence rate but increased hypothyroidism in Graves' disease.