Endocrinol Metab.  2024 Aug;39(4):659-663. 10.3803/EnM.2024.2042.

Treatment Patterns and Preferences for Graves’ Disease in Korea: Insights from a Nationwide Cohort Study

• Kim KJ
• Choi J
• Shin SM
• Kim JA
• Kim KJ
• Kim SG

• KMID: 2558950
• DOI: http://doi.org/10.3803/EnM.2024.2042

Abstract

Treatment patterns and preferences for patients with Graves’ disease (GD) vary across countries. In this study, we assessed the initial therapies and subsequent treatment modalities employed for GD in real-world clinical practice in Korea. We analyzed 452,001 patients with GD from 2004 to 2020, obtained from the Korean National Health Insurance Service database. Initial treatments included antithyroid drug (ATD) therapy (98% of cases), thyroidectomy (1.3%), and radioactive iodine (RAI) therapy (0.7%). The rates of initial treatment failure were 58.5% for ATDs, 21.3% for RAI, and 2.1% for thyroidectomy. Even among cases of ATD treatment failure or recurrence, the rates of RAI therapy remained low. Regarding initial treatment, the 5-year remission rate was 46.8% among patients administered ATDs versus 91.0% among recipients of RAI therapy; at 10 years, these rates were 59.2% and 94.0%, respectively. Our findings highlight a marked disparity in the use of RAI therapy in Korea compared to Western countries. Further research is required to understand the reasons for these differences in treatment patterns.

Keyword

Graves disease; Therapeutics; Practice patterns, physicians’

Figure

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  Fig. 1. Treatment pathway following initial antithyroid drug (ATD) therapy. The horizontal axis indicates the duration of follow-up, truncated at 12 years. RAI, radioactive iodine.

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  Fig. 2. Treatment pathway following initial radioactive iodine (RAI) therapy. The horizontal axis indicates the duration of follow-up, truncated at 8 years. ATD, antithyroid drug.

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