TRAb value > 1.1IU/L "Graves disease" has a high risk of recurrence |2022ATA

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Introduction: A positive thyrotropin receptor antibody (TRAb) is a risk factor for predicting recurrence of Graves' disease (Graves, GD), but its cut-off value has not been determined
.

A study found that TRAb values > 1.
1 IU/L were associated with a higher risk of recurrence, which was presented at
the 2022 American Thyroid Association Annual Meeting (2022ATA).

Determine the cut-off value of TRAb to assess the risk of recurrence

GD is the main cause of
hyperthyroidism.
Although studies have shown that TRAb positivity after treatment with antithyroid drugs is associated with a higher risk of recurrence, there is no established cut-off value
for this parameter.
We aimed to assess the values of TRAb, thyroid-stimulating hormone (TSH) and free T4 (fT4) and the duration of treatment associated with an increased risk of
disease recurrence.

The study evaluated the treatment of 36 patients diagnosed with GD, including those
with hyperthyroidism and TRAb values > 1.
75 IU/L.
Prior treatment for GD, pregnant women, and patients
younger than 20 years of age were excluded.
Variables were assessed for sex, age, TRAb, TSH, and fT4 values at diagnosis, and duration
of antithyroid therapy.

After 1-2 years of treatment, all variables were associated with GD remission (normal TSH and fT4 and TRAb < 1.
75 IU/L), using a cut-off value of 10 IU/L to define high or low
TRAb values.
Fisher and chi-square tests were used for statistical analysis, and P<0.
05 was statistically significant
.

Patients with TRAb> 1.
1 IU/L have a high risk of recurrence

Patients are predominantly female (80%), 42% older than 40 years; 50% of patients were treated for 1 year and another 50% for 2 years
.

1.
72% of patients had disease remission within 2 years of treatment, of which 77% were women (P = 0.
645) and 70% were 30-50 years old (P = 0.
458).

2.
In the remission group, 62% of patients received 2 years of treatment (P=0.
026), of which 65% of patients had TRAb<10UI/L (P=0.
025).

3.
At the end of treatment, patients (29%) with TRAb values > 1.
15UI/L had relapse (P=0.
005), TSH and fT4 values at diagnosis, most of which were below 0.
005mIU/L and higher than 7.
7ng/dL, respectively, and the proportion of maintaining these patterns in the remission group was 65% (P=0.
223) and 81% (P=0.
100),
respectively.

Summary of this article

In the patients studied, TRAb>1.
1 IU/L was statistically significant
in determining the risk of recurrence, although most of the indicators were within the normal reference range.
This suggests that TRAb>1.
1 IU/L has the potential to be used to distinguish patients at higher risk of recurrence even in antibody-negative patients
.

REFERENCE: LONG‐TERM MORTALITY AND CARDIOMETABOLIC EFFECTS OF TREATMENT FOR HYPERTHYROIDISM: EGRET STUDY.
THYROIDVolume 32， Supplement 1，2022.
https：//doi.
org/10.
1089/thy.
2022.
29140.
lb.
abstracts