Short-Term Effects of β-adrenergic Antagonists and Methimazole in New-Onset Thyrotoxicosis Caused by Graves' Disease
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概要
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Objective β-adrenergic antagonists (β-blockers) are often used to attenuate the hyperadrenergic symptoms of Graves' disease (GD), including palpitation. Although β-blockers reduce the heart rate, cardiac output and oxygen consumption, no firm evidence exists regarding the effects of combined therapy with β-blockers and anti-thyroid drugs. The objective is to elucidate the effects of β-blockers on anti-thyroid drug therapy in GD. Methods Patients newly diagnosed with mild GD were randomly assigned to receive methimazole with or without β-blockers in a prospective multi-center survey. The heart rate and thyroid function were measured and the quality of life was assessed using original and SF-36 questionnaires at 0 and 4 weeks. Results A total of 28 patients were enrolled in the study. Fourteen patients (one man, 13 women) were randomly assigned to the group treated with β-blockers and 14 patients (one man, 13 women) were randomly assigned to the group not treated with β-blockers. Although no significant differences in the improvement of thyroid function were observed between the two groups, the heart rates improved more significantly in the group treated with β-blockers. Specific symptoms, such as easy fatigability and shortness of breath, also improved more significantly with the β-blocker treatment. In addition, 'physical functioning' assessed with the SF-36 questionnaires significantly improved only in the group treated with β-blockers. Conclusion Although β-blockers may not reinforce the effects of anti-thyroid drugs on thyroid function, at least during the course of one month, they are effective in reducing heart rates and ameliorating specific symptoms in patients with mild GD.
著者
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Ogo Atsushi
Department Of Metabolism And Endocrinology Clinical Research Institute National Hospital Organizatio
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Usui Takeshi
Clinical Research Institute Division Of Endocrinology And Metabolism Kyoto Medical Center National H
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Naruse Mitsuhide
Clinical Endocrinology Department Of Medicine Tokyo Women's Medical College
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Tagami Tetsuya
Clinical Research Institute Division Of Endocrinology And Metabolism Kyoto Medical Center National H
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Tanaka Tsuyoshi
Department Of Bioresources Chemistry Faculty Of Agriculture Okayama University
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Yoshizumi Hideyuki
Department Of Metabolism And Endocrinology Clinical Research Institute National Hospital Organizatio
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Tanaka Takashi
Department Of Central Clinical Laboratory Teikyo University Hospital
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Shimatsu Akira
Clinical Res. Inst. Kyoto Medical Center National Hospital Organization
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Shimatsu Akira
Clinical Research Institute, Division of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Japan
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Higashi Kiichiro
Department of Diabetes and Endocrinology, National Hospital Organization Kumamoto Medical Center, Japan
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Usui Takeshi
Clinical Research Institute, Division of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Japan
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Yambe Yuko
Department of Endocrinology and Metabolism, National Hospital Organization Nagoya Medical Center, Japan
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Kaise Kazuo
Department of General Medicine, National Hospital Organization Sendai Medical Center, Japan
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Tanabe Makito
Division of Internal Medicine, National Hospital Organization Kokura Medical Center, Japan
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Shimazu Satoko
Clinical Research Institute, Division of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Japan
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Tagami Tetsuya
Clinical Research Institute, Division of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Japan
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Naruse Mitsuhide
Clinical Research Institute, Division of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Japan
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