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©2013 UpToDate ® Print Email Controversies about antithyroid drug use Controversy Best available answer For how long should patients be treated? 12-18 months Does the dose influence the chances of remission? Probably not Do higher doses bring the disease under more rapid control? Yes Does the coadministration or subsequent use of T4 or T3 improve remission rates? No Are there baseline predictors of the likelihood of remission? Severe disease, large goiter, high anti-TSH receptor antibody titers may be predictive of failure, but only in extreme cases Does pretreatment with antithyroid drugs decrease the chancesof thyroid storm or other adverse outcomes after radioiodine therapy? Possibly, but only because thyroid hormone levels are lower after therapy in those few patients who exhibit an exacerbation Will antithyroid drug therapy after radioiodine lead to more rapid disease control? PTU, no (at 6 wk); methimazole, yes Adapted with permission from: Cooper DC. Antithyroid drugs in the management of patients with Graves' disease: An evidence-based approach to therapeutic controversies. J Clin Endocrinol Metab 2003; 88:3474. file://jcem.endojournals.org/. Copyright © 2003 The Endocrine Society.