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Taylor PN, Vaidya B. Side effects of anti-thyroid drugs and their impact on the choice of treatment for thyrotoxicosis in pregnancy. Eur Thyroid J. 2012;1(3):176-85doi: 10.1159/000342920.
Taylor, P. N., & Vaidya, B. (2012). Side effects of anti-thyroid drugs and their impact on the choice of treatment for thyrotoxicosis in pregnancy. European thyroid journal, 1(3), 176-85. https://doi.org/10.1159/000342920
Taylor, Peter N, and Vaidya, Bijay. "Side effects of anti-thyroid drugs and their impact on the choice of treatment for thyrotoxicosis in pregnancy." European thyroid journal vol. 1,3 (2012): 176-85. doi: https://doi.org/10.1159/000342920
Taylor PN, Vaidya B. Side effects of anti-thyroid drugs and their impact on the choice of treatment for thyrotoxicosis in pregnancy. Eur Thyroid J. 2012 Oct;1(3):176-85. doi: 10.1159/000342920. Epub 2012 Sep 24. PMID: 24783017; PMCID: PMC3821480.
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Eur Thyroid J. 2012 Oct;1(3):176-85. doi: 10.1159/000342920. Epub 2012 Sep 24.

Side effects of anti-thyroid drugs and their impact on the choice of treatment for thyrotoxicosis in pregnancy.

European thyroid journal

Peter N Taylor, Bijay Vaidya

Affiliations

  1. Thyroid Research Group, Institute of Experimental and Molecular Medicine, School of Medicine, Cardiff University, Cardiff, London ; London School of Hygiene and Tropical Medicine, London.
  2. Department of Endocrinology, Royal Devon and Exeter Hospital and Peninsula Medical School, Exeter, UK.

PMID: 24783017 PMCID: PMC3821480 DOI: 10.1159/000342920

Abstract

INTRODUCTION: Hyperthyroidism in pregnancy is a serious condition and its management is complex. Whilst carbimazole/methimazole (CBZ/MMI) and propylthiouracil (PTU) have similar efficacies in controlling hyperthyroidism, their risk of side effects such as major congenital abnormalities and hepatotoxicity are different.

METHODS: Various combinations of the terms 'anti-thyroid drugs', 'thionamide', 'carbimazole', 'methimazole', 'propylthiouracil', 'pregnancy', 'side effects', 'agranulocytosis', 'birth defects', 'congenital malformations', 'embryopathy', 'aplasia cutis', 'hepatotoxicity', 'hepatic failure', 'maternal' and 'fetus' were used to search MEDLINE and the Cochrane library. The references of retrieved papers were also reviewed.

RESULTS: There is increasing evidence for a CBZ/MMI embryopathy, whilst data remain lacking for major congenital abnormalities with PTU. In contrast, PTU is associated with increased risk of severe liver injury. Management strategies to reduce these risks by using PTU in the first trimester and CBZ/MMI in the later trimesters remain untested.

CONCLUSION: More evidence is still needed in defining the relative risks between CBZ/MMI and PTU of major congenital abnormalities and severe liver injury in pregnancy. Studies are also needed to establish the suitability of recent management suggestions in switching from PTU to CBZ/MMI after the first trimester. Major adverse outcomes secondary to CBZ/MMI and PTU are rare, and inadequately treated hyperthyroidism poses a far greater risk.

Keywords: Agranulocytosis; Carbimazole; Congenital malformation; Embryopathy; Hepatotoxicity; Methimazole; Pregnancy; Propylthiouracil; Thionamide; Thyroid

References

  1. N Engl J Med. 1981 Feb 26;304(9):525-8 - PubMed
  2. Am J Med Genet. 1987 Dec;28(4):931-4 - PubMed
  3. PLoS One. 2012;7(4):e35213 - PubMed
  4. Nat Rev Endocrinol. 2011 Mar 15;7(7):396-406 - PubMed
  5. Liver Transpl. 2009 Jul;15(7):719-29 - PubMed
  6. J Clin Endocrinol Metab. 2001 Jun;86(6):2354-9 - PubMed
  7. Eur Thyroid J. 2012 Apr;1(1):24-9 - PubMed
  8. Clin Pharm. 1982 Sep-Oct;1(5):471-4 - PubMed
  9. J Pediatr Endocrinol Metab. 2011;24(3-4):215-8 - PubMed
  10. Arch Surg. 2009 May;144(5):399-406; discussion 406 - PubMed
  11. Clin Endocrinol (Oxf). 1984 Jun;20(6):695-700 - PubMed
  12. Thyroid. 2011 Oct;21(10):1081-125 - PubMed
  13. J Thyroid Res. 2011;2011:235130 - PubMed
  14. Thyroid. 2011 Apr;21(4):335-46 - PubMed
  15. Am J Med Genet A. 2008 Sep 15;146A(18):2390-5 - PubMed
  16. Korean J Intern Med. 2005 Dec;20(4):335-8 - PubMed
  17. Endocrinol Metab Clin North Am. 2006 Mar;35(1):117-36, vii - PubMed
  18. Lancet. 1979 Nov 10;2(8150):1011 - PubMed
  19. Int J Pediatr Endocrinol. 2009;2009:132041 - PubMed
  20. J Clin Endocrinol Metab. 2012 Jul;97(7):2396-403 - PubMed
  21. J Clin Endocrinol Metab. 1997 Sep;82(9):3099-102 - PubMed
  22. QJM. 2012 Feb;105(2):189-93 - PubMed
  23. Am J Obstet Gynecol. 1989 Jan;160(1):63-70 - PubMed
  24. Korean J Intern Med. 2006 Dec;21(4):240-3 - PubMed
  25. Am J Med Genet A. 2005 Jan 15;132A(2):130-5 - PubMed
  26. J Clin Endocrinol Metab. 2010 Nov;95(11):E337-41 - PubMed
  27. J Clin Endocrinol Metab. 2010 May;95(5):2227-33 - PubMed
  28. Obstet Gynecol. 1994 Dec;84(6):946-9 - PubMed
  29. Cochrane Database Syst Rev. 2010 Sep 08;(9):CD008633 - PubMed
  30. Hum Reprod Update. 2012 Jul;18(4):360-73 - PubMed
  31. J Clin Endocrinol Metab. 2012 Aug;97(8):2543-65 - PubMed
  32. Curr Opin Endocrinol Diabetes Obes. 2012 Oct;19(5):402-7 - PubMed
  33. Lancet. 1978 Aug 12;2(8085):370-1 - PubMed
  34. Clin Transpl. 1989;:311 - PubMed
  35. Med Clin North Am. 1991 Jan;75(1):121-50 - PubMed
  36. J Endocrinol Invest. 1990 Dec;13(11):937-41 - PubMed
  37. J Clin Endocrinol Metab. 1986 Jan;62(1):217-20 - PubMed
  38. J Clin Endocrinol Metab. 2010 Jul;95(7):3260-7 - PubMed
  39. Ir J Med Sci. 2008 Mar;177(1):69-71 - PubMed
  40. J Clin Endocrinol Metab. 2007 Jun;92(6):2157-62 - PubMed
  41. Eur Thyroid J. 2012 Apr;1(1):30-3 - PubMed
  42. Eur J Endocrinol. 2011 Jun;164(6):871-6 - PubMed
  43. Eur Thyroid J. 2012 Apr;1(1):34-40 - PubMed
  44. Obstet Gynecol. 2010 Aug;116 Suppl 2:485-487 - PubMed
  45. Endocr Pract. 2011 May-Jun;17(3):456-520 - PubMed
  46. J Pediatr Orthop. 2008 Jun;28(4):432-4 - PubMed
  47. J Clin Endocrinol Metab. 2002 Feb;87(2):947-9 - PubMed
  48. Ann Pharmacother. 2003 Feb;37(2):224-8 - PubMed
  49. Br J Clin Pharmacol. 2009 Oct;68(4):609-17 - PubMed
  50. Teratology. 2001 Nov;64(5):262-6 - PubMed
  51. Lancet. 1992 Mar 21;339(8795):742-3 - PubMed
  52. Clin Exp Obstet Gynecol. 2002;29(4):304-5 - PubMed
  53. J Clin Endocrinol Metab. 1997 Jun;82(6):1727-33 - PubMed
  54. Am J Obstet Gynecol. 1996 Apr;174(4):1306-11 - PubMed
  55. Am J Obstet Gynecol. 1994 Jan;170(1 Pt 1):90-5 - PubMed
  56. Ann Intern Med. 1987 Jan;106(1):60-1 - PubMed
  57. Teratology. 1973 Feb;7(1):3-15 - PubMed
  58. Am J Gastroenterol. 2001 Jan;96(1):165-9 - PubMed
  59. Thyroid. 1994 Spring;4(1):129-33 - PubMed
  60. Endocr Rev. 2010 Oct;31(5):702-55 - PubMed
  61. Ann Endocrinol (Paris). 2010 Dec;71(6):535-42 - PubMed
  62. J Clin Endocrinol Metab. 1997 Nov;82(11):3633-6 - PubMed
  63. J Endocrinol Invest. 2002 Jul-Aug;25(7):586-9 - PubMed
  64. J Clin Endocrinol Metab. 2009 Jun;94(6):1881-2 - PubMed
  65. J Toxicol Sci. 2001 Feb;26(1):39-50 - PubMed
  66. Obstet Gynecol. 2002 Aug;100(2):387-96 - PubMed
  67. Eur Thyroid J. 2012 Apr;1(1):41-4 - PubMed
  68. Clin Endocrinol (Oxf). 2001 Apr;54(4):559-61 - PubMed
  69. Eur J Endocrinol. 2009 Jan;160(1):1-8 - PubMed
  70. Ann Intern Med. 1993 Mar 15;118(6):424-8 - PubMed
  71. Ann Intern Med. 1984 Aug;101(2):283 - PubMed
  72. QJM. 2011 Nov;104(11):945-56 - PubMed
  73. Br Med Bull. 2011;97:137-48 - PubMed
  74. Eur J Pediatr. 1992 Aug;151(8):558-9 - PubMed
  75. Clin Endocrinol (Oxf). 2004 Nov;61(5):589-94 - PubMed
  76. J Med Case Rep. 2011 Sep 19;5:461 - PubMed
  77. J Clin Endocrinol Metab. 1977 Dec;45(6):1187-93 - PubMed
  78. BJOG. 2011 Oct;118(11):1365-73 - PubMed
  79. N Engl J Med. 2005 Mar 3;352(9):905-17 - PubMed

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