Thyroidectomy Beneficial but Risky for Hashimoto Disease

Thyroidectomy Beneficial but Risky for Hashimoto Disease

TOPLINE:

In patients with Hashimoto disease and persistent symptoms despite adequate medical treatment, total thyroidectomy had a beneficial effect up to 5 years but with a substantially higher risk for complications than initially anticipated.

METHODOLOGY:

The 5-year follow-up of 65 participants in a randomized, open-label trial of thyroidectomy plus medical management vs medical management alone aimed at testing the hypothesis that persistent symptoms despite adequate thyroxine replacement may be related to extrathyroidal autoimmune reactions and that complete removal of thyroid tissues may attenuate autoimmune responses and relieve symptoms.Patients in the control group were given the option of having surgery 18 months after enrollment, depending on trial results.The primary outcome was patient-reported health-related quality of life measured by the dimensional general health score in the generic Short Form-36 Health Survey questionnaire.

TAKEAWAY:

The positive treatment effect seen after 18 months was maintained throughout the 3-year follow-up.In the intervention group, the improved general health score remained at the same level during the 5-year follow-up.Results were similar for the other Short Form-36 Health Survey domains and for total fatigue and chronic fatigue.Short-term (
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