Nonthionamide Drugs for the Treatment of Hyperthyroidism: From Present to Future

Overview

Journal Int J Endocrinol

Publisher Wiley

Specialty Endocrinology

Date 2018 Jun 1

PMID 29849619

Citations 13

Authors

Nattakarn Suwansaksri

Lukana Preechasuk

Tada Kunavisarut

Affiliations

Soon will be listed here.

Abstract

Hyperthyroidism is a common endocrine disease. Although thionamide antithyroid drugs are the cornerstone of hyperthyroidism treatment, some patients cannot tolerate this drug class because of its serious side effects including agranulocytosis, hepatotoxicity, and vasculitis. Therefore, nonthionamide antithyroid drugs (NTADs) still have an important role in controlling hyperthyroidism in clinical practice. Furthermore, some situations such as thyroid storm or preoperative preparation require a rapid decrease in thyroid hormone by combination treatment with multiple classes of antithyroid drugs. NTADs include iodine-containing compounds, lithium carbonate, perchlorate, glucocorticoid, and cholestyramine. In this narrative review, we summarize the mechanisms of action, indications, dosages, and side effects of currently used NTADs for the treatment of hyperthyroidism. In addition, we also describe the state-of-the-art in future drugs under development including rituximab, small-molecule ligands (SMLs), and monoclonal antibodies with a thyroid-stimulating hormone receptor (TSHR) antagonist effect.

Citing Articles

Preoperative Preparation in Hyperthyroidism and Surgery in the Hyperthyroid State.

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Could effective iodine-131 half-life be extended by lithium carbonate in Graves' disease patients: Results from a retrospective analysis.

Gao X, Wu B, Zhou Q, Liu Y, Wang R Biomol Biomed. 2024; 24(6).

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Exogenous Melatonin Protects against Oxidative Damage to Membrane Lipids Caused by Some Sodium/Iodide Symporter Inhibitors in the Thyroid.

Gladysz A, Stepniak J, Karbownik-Lewinska M Antioxidants (Basel). 2023; 12(9).

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Thyroid storm caused by metastatic papillary thyroid carcinoma tissue after total thyroidectomy: a case report.

Kwon S, Kim M, Jung S, Jeon J J Yeungnam Med Sci. 2023; 40(Suppl):S93-S97.

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Clinical Review and Update on the Management of Thyroid Storm.

De Almeida R, McCalmon S, Cabandugama P Mo Med. 2022; 119(4):366-371.

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References

Grandjean E, Aubry J . Lithium: updated human knowledge using an evidence-based approach. Part II: Clinical pharmacology and therapeutic monitoring. CNS Drugs. 2009; 23(4):331-49. DOI: 10.2165/00023210-200923040-00005. View

Ross D, Burch H, Cooper D, Greenlee M, Laurberg P, Maia A . 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Thyroid. 2016; 26(10):1343-1421. DOI: 10.1089/thy.2016.0229. View

NORTHCUTT R, Stiel J, Hollifield J, STANT Jr E . The influence of cholestyramine on thyroxine absorption. JAMA. 1969; 208(10):1857-61. View

Nayak B, Burman K . Thyrotoxicosis and thyroid storm. Endocrinol Metab Clin North Am. 2006; 35(4):663-86, vii. DOI: 10.1016/j.ecl.2006.09.008. View

Eng P, Cardona G, Fang S, Previti M, Alex S, Carrasco N . Escape from the acute Wolff-Chaikoff effect is associated with a decrease in thyroid sodium/iodide symporter messenger ribonucleic acid and protein. Endocrinology. 1999; 140(8):3404-10. DOI: 10.1210/endo.140.8.6893. View

Wartofsky L, Ransil B, Ingbar S . Inhibition by iodine of the release of thyroxine from the thyroid glands of patients with thyrotoxicosis. J Clin Invest. 1970; 49(1):78-86. PMC: 322446. DOI: 10.1172/JCI106225. View

Burgi H . Iodine excess. Best Pract Res Clin Endocrinol Metab. 2010; 24(1):107-15. DOI: 10.1016/j.beem.2009.08.010. View

Williams J, Berens S, Wolff J . Thyroid secretion in vitro: inhibition of TSH and dibutyryl cyclic-AMP stimulated 131-I release by Li+1. Endocrinology. 1971; 88(6):1385-8. DOI: 10.1210/endo-88-6-1385. View

Davies T, Latif R . Targeting the thyroid-stimulating hormone receptor with small molecule ligands and antibodies. Expert Opin Ther Targets. 2015; 19(6):835-47. PMC: 4484771. DOI: 10.1517/14728222.2015.1018181. View

10.

Neumann S, Huang W, Eliseeva E, Titus S, Thomas C, Gershengorn M . A small molecule inverse agonist for the human thyroid-stimulating hormone receptor. Endocrinology. 2010; 151(7):3454-9. PMC: 2903937. DOI: 10.1210/en.2010-0199. View

11.

Inaba H, De Groot L, Akamizu T . Thyrotropin Receptor Epitope and Human Leukocyte Antigen in Graves' Disease. Front Endocrinol (Lausanne). 2016; 7:120. PMC: 4994058. DOI: 10.3389/fendo.2016.00120. View

12.

Philippou G, Koutras D, Piperingos G, Souvatzoglou A, Moulopoulos S . The effect of iodide on serum thyroid hormone levels in normal persons, in hyperthyroid patients, and in hypothyroid patients on thyroxine replacement. Clin Endocrinol (Oxf). 1992; 36(6):573-8. DOI: 10.1111/j.1365-2265.1992.tb02267.x. View

13.

Gershengorn M, Neumann S . Update in TSH receptor agonists and antagonists. J Clin Endocrinol Metab. 2012; 97(12):4287-92. PMC: 3513532. DOI: 10.1210/jc.2012-3080. View

14.

Chopra I, Williams D, Orgiazzi J, Solomon D . Opposite effects of dexamethasone on serum concentrations of 3,3',5'-triiodothyronine (reverse T3) and 3,3'5-triiodothyronine (T3). J Clin Endocrinol Metab. 1975; 41(5):911-20. DOI: 10.1210/jcem-41-5-911. View

15.

Soldin O, Braverman L, Lamm S . Perchlorate clinical pharmacology and human health: a review. Ther Drug Monit. 2001; 23(4):316-31. PMC: 3640367. DOI: 10.1097/00007691-200108000-00002. View

16.

Hegedus L, Smith T, Douglas R, Nielsen C . Targeted biological therapies for Graves' disease and thyroid-associated ophthalmopathy. Focus on B-cell depletion with Rituximab. Clin Endocrinol (Oxf). 2010; 74(1):1-8. PMC: 4053536. DOI: 10.1111/j.1365-2265.2010.03806.x. View

17.

Temple R, Berman M, Robbins J, Wolff J . The use of lithium in the treatment of thyrotoxicosis. J Clin Invest. 1972; 51(10):2746-56. PMC: 332975. DOI: 10.1172/JCI107094. View

18.

Evans M, Sanders J, Tagami T, Sanders P, Young S, Roberts E . Monoclonal autoantibodies to the TSH receptor, one with stimulating activity and one with blocking activity, obtained from the same blood sample. Clin Endocrinol (Oxf). 2010; 73(3):404-12. DOI: 10.1111/j.1365-2265.2010.03831.x. View

19.

Wolff J, CHAIKOFF I . Plasma inorganic iodide as a homeostatic regulator of thyroid function. J Biol Chem. 1948; 174(2):555-64. View

20.

Williams D, Chopra I, Orgiazzi J, Solomon D . Acute effects of corticosteroids on thyroid activity in Graves' disease. J Clin Endocrinol Metab. 1975; 41(2):354-61. DOI: 10.1210/jcem-41-2-354. View