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- Although both drugs effectively control hyperthyroidism, observations over several decades have shown that MMI and its prodrug carbimazole are better than PTU in controlling more severe hyperthyroidism, having higher adherence rates, and causing less toxicity, especially when prescribed in lower doses (1).
academic.oup.com › jcem › articlePutting Propylthiouracil in Perspective | The Journal of ...
Jul 7, 2021 · Although MMI might have higher risk of hypothyroidism than PTU, the efficacy of MMI may be better than PTU in patients with hyperthyroidism regarding reducing T 3, T 4, FT 3, and FT 4 levels, decreasing the risk of liver function damage and increasing the level of thyroid-stimulating hormone.
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(Table2 2 - The efficiency and safety of methimazole and...
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(Fig.5 a 5 - The efficiency and safety of methimazole and...
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Figure4 B 4 - The efficiency and safety of methimazole and...
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- Antithyroid Drug Use in The United States From 1991 to 2008
Context: The thionamide antithyroid drugs methimazole and...
- Excess Mortality in Hyperthyroidism
Hyperthyroidism is a common disease, with a lifetime risk of...
- Effect of Anti-Thyroid Agents, Methimazole and Propylthiouracil, on Brain Noradrenaline Content
This inhibition by MMI and PTU was dose-dependent over the...
- Propylthiouracil Increases Sodium/Iodide Symporter Gene Expression and Iodide Uptake in Rat Thyroid Cells in The Absence of TSH
Introduction. G raves' disease is one of the most frequent...
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When patients were divided into two groups by initial FT4, in the group of the patients with severe hyperthyroidism (FT4, 7 ng/dl or more, 64 patients) MMI 30 mg/d normalized FT4 more effectively than PTU 300 mg/d at 8 and 12 wk and MMI 15 mg/d at 8 wk, respectively (P < 0.05).
- Hirotoshi Nakamura, Jaeduk Yoshimura Noh, Koichi Itoh, Shuji Fukata, Akira Miyauchi, Noboru Hamada
- 2007
- Abstract
- Patients and Methods
- Results
- Discussion
- Acknowledgments
- Abbreviations
DESPITE METHIMAZOLE (MMI) and propylthiouracil (PTU) having been used for more than half a century to treat hyperthyroidism caused by Graves’ disease (GD), controversy still exists in antithyroid drug (ATD) therapy. For example, according to a survey reported in 1991, MMI was selected as the drug for initial treatment in Japan and Europe, whereas P...
Patients
Only patients with untreated hyperthyroidism due to GD were recruited. GD was diagnosed according to Japan Thyroid Association’s diagnosis guidelines (http://thyroid.umin.ac.jp/en/frame.html), defined by clinical findings and the determination of serum free T4 (FT4), free T3 (FT3), TSH, TSH receptor antibody (TRAb), and 123I- or 99mTc-uptake. The following conditions excluded patients from the study: age younger than 16 yr old; pregnancy; relapsed patients after subtotal thyroidectomy or radi...
Study design
This study was conducted as an open prospective randomized trial, with an observation period of 12 wk. Four hospitals in Japan, Ito Hospital in Tokyo, Kuma Hospital in Kobe, Sumire Hospital in Osaka, and Hamamatsu University Hospital in Hamamatsu, participated in the study. The Ethical Committee of Hamamatsu University School of Medicine and each hospital involved in the study approved the protocol. All eligible patients with untreated GD seen by the four participating hospitals from October...
Methods
Serum FT4, FT3, and TSH were measured with a Roche ECLusys kit (Roche, Basel, Switzerland) in Ito Hospital, Sumire Hospital, and Hamamatsu University Hospital, or Architect kits (Abbott Japan Co., Ltd, Osaka 540-0001 Japan) in Kuma Hospital. Although values for the hormones obtained by these two assay kits differed slightly, the data were combined for the analyses because the difference was small (data not shown). The normal values and measurable ranges are as follows: FT4 0.8–1.6 ng/dl (meas...
Comparisons of the efficiency of the MMI 30 mg/d treatment with that of the PTU 300 mg/d and MMI 15 mg/d treatment
At 4 wk after initial treatment, serum FT4 levels went down less than 1.7 ng/dl in 52.7%, 38.4%, and 36.7% of the patients treated with MMI 30 mg/d, PTU 300 mg/d, and MMI 15 mg/d, respectively. MMI 15 mg/d was significantly less effective than MMI 30 mg/d (P = 0.023). At 8 wk, their ratios were 81.3%, 68.5%, and 70.0%, respectively, and the statistical difference between MMI 30 mg/d with PTU 300 mg/d and MMI 15 mg/d was marginal. At 12 wk, the efficacy was significantly different between them...
Comparison of adverse events between MMI 30 mg/d and PTU 300 mg/d or MMI 15 mg/d
Table 3 summarizes the incidence of adverse effects in the ATD regimen groups. The incidence was surprisingly high in the PTU group, in which more than half the patients (54 of 104) had some adverse effects. PTU was stopped or changed to MMI for 39 patients. In the MMI 30-mg group, adverse effects occurred in 39 of 130 patients (30%), and the drug was stopped or changed for 28 patients. The difference was statistically significant between the PTU group and the MMI 30-mg group. We found a very...
There have been only limited studies that compared the effectiveness of MMI and PTU to treat hyperthyroidism caused by GD. Okamura et al. (5) reported that MMI 30 mg/d normalized more rapidly TH than PTU 300 mg/d. The mean time required to normalize TH was 6.7 ± 4.6 wk by MMI and 16.8 ± 13.7 wk by PTU (P < 0.05). However, their study was retrospect...
The members of the Working Group of the Japan Thyroid Association for the Guideline of the Treatment of Graves’ Disease are Yoshifumi Abe, Nobuyuki Amino, Koichi Ito, Makoto Iitaka, Ken Okamura, Yasunori Ozawa, Keiichi Kamijo, Jun Sasaki, Yoshimasa Shishiba, Yuji Tanaka, Junichi Tajiri, Toshio Tsushima, Hirotoshi Nakamura (chairman), Noboru Hamada,...
ALT,Alanine aminotransferase;AST,aspirate aminotransferase;ATD,antithyroid drug;GD,Graves’ disease;- Hirotoshi Nakamura, Jaeduk Yoshimura Noh, Koichi Itoh, Shuji Fukata, Akira Miyauchi, Noboru Hamada
- 2007
MMI and PTU are the main antithyroid drugs for the treatment of hyperthyroidism. MMI is preferred in non-pregnant patients because PTU can rarely cause liver problems, but is less preferred in pregnancy due to an increased risk of birth defects.
Jun 1, 2009 · Although both drugs effectively control hyperthyroidism, observations over several decades have shown that MMI and its prodrug carbimazole are better than PTU in controlling more severe hyperthyroidism, having higher adherence rates, and causing less toxicity, especially when prescribed in lower doses . This has led to the recommendation that ...
- David S. Cooper, Scott A. Rivkees
- 2009
May 19, 2023 · Our research provides an important population-based assessment of ATDs which shows that it is safer to use PTU during pregnancy than MMI with hyperthyroidism. Furthermore, there is no evidence that switching between PTU and MMI is greater than using PTU alone.
May 18, 2004 · Serum TT3, TT4 and FT4 levels in the MMI-treated group were significantly lower than those of the PTU-treated group after 4 weeks and through the end of the study. MMI also has superior effect on reducing serum TRAb levels than PTU after 8 weeks and at the end of the study.
