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Table 4 Mortality studies in hyperthyroidism: treatment groups vs disease controls

From: Should radioiodine now be first line treatment for Graves’ disease?

Author (ref)YearCountrySettingNo of patientsTotal/CV mortality RR (95%CI)Cancer mortality RR (95%CI)
RAI vs Thyroidectomy
 Hoffman [20]1982USAHospital1005 vs 2141 (RAI vs T)No difference; RR 1.0 (0.9, 1.2)No difference; RR 1.0 (0.7, 1.3) (a)
 Ryodi [21, 22]2015, 2018FinlandRegistry1814 vs 4334 (RAI vs T)Increased; HR 2.1 (1.7, 2.5) (b)No difference; RR 1.0 (0.9, 1.2)
 Giesecke [23]2017SwedenRegistry10,250 vs 742 (RAI vs T)Increased; HR 1.2 (1.0,1.4)No difference; HR 0.96 (0.73, 1.3)
RA1 vs ATD
 Boelaert [7]2013UKHospital764 vs 272 (RAI-Grp A vs ATD) (7a)Reduced; HR 0.7 (0.5, 0.9)NA
764 vs 272 (RAI-Grp B vs ATD) (7b)No difference; HR 0.9 (0.7, 1.3)NA
 Okosieme [8]2019UKRegistry250 vs 3587 (RAI-Grp A vs ATD) (8a)Reduced; HR 0·5 (0·3, 0.9)NA
182 vs 3587 (RAI-Grp B vs ATD) (8b)No difference; HR 1·5, (0·9, 2·4)NA
 Gronich [24]2020UKDatabase2829 vs 13,808 (RAI vs ATD)Reduced; HR 0.83 (0.72, 0.95)No difference; HR 1.0 (0.8, 1.2) (a)
  1. RR relative risks, CI confidence interval, CV cardiovascular, RAI Radioactive Iodine, T Thyroidectomy, ATD Antithyroid Drugs, SMR Standardised Mortality Ratio
  2. (a), RR/HR for cancer incidence, (b), HR for CV mortality. (7a, 7b) For reference [7], HR are based on person years accumulated after RAI and on Levothyroxine (RAI-Grp A) or person years after RAI but not taking or before taking Levothyroxine (RAI-Grp B) vs person years on thionamide alone (ATD). (8a, 8b) For reference [8], radioiodine groups were divided into patients with resolved hyperthyroidism after radioiodine (RAI-Grp A) and patients with unresolved hyperthyroidism after radioiodine (RAI-Grp B)