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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)

Year

Country

Setting

No of patients

Total/CV mortality RR (95%CI)

Cancer mortality RR (95%CI)

RAI vs Thyroidectomy

 Hoffman [20]

1982

USA

Hospital

1005 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, 2018

Finland

Registry

1814 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]

2017

Sweden

Registry

10,250 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]

2013

UK

Hospital

764 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]

2019

UK

Registry

250 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]

2020

UK

Database

2829 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)