Radioiodine ¹³¹I therapy of hyperthyroidism on an outpatient basis – safe, effective and economic option

Czech version

Authors: J. Jiskra ¹; J. Kubinyi ²; Z. Telička ¹
Authors‘ workplace: III. interní klinika 1. lékařské fakulty UK a VFN Praha, přednosta prof. MUDr. Štěpán Svačina, DrSc., MBA ¹; Ústav nukleární medicíny 1. lékařské fakulty UK a VFN Praha, přednosta prof. MUDr. Martin Šámal, DrSc. ²
Published in: Vnitř Lék 2012; 58(2): 94-98
Category: Original Contributions

Overview

Introduction:
Radioiodine ¹³¹I therapy of hyperthyroidism on an outpatient basis is widely accepted over the world. In Czech Republic, however, radioiodine therapy is still not enough used, and has been realized on an inpatient basis to date. Our work is the first analysis of the experiences with radioiodine therapy of hyperthyroidism on an outpatient basis in Czech Republic.

Methods:
Capsule with 550 MBq of ¹³¹I was administered orally in 39 hyperthyroid patients (32 women and 8 men, 21 with autoimmune Graves’ hyperthyroidism and 18 with toxic thyroid nodules, mean age 66.8 years). In 32 of them we evaluated effectiveness and complications of therapy after 12–42 months. We also compared financial costs of the radioiodine treatment on an outpatient basis with the treatment in hospitalization and with surgery.

Results:
After the treatment, 9/32 (28 %) patients were euthyroid without thyrostatic/thyroxine treatment, 18/32 (60 %) patients were hypothyroid with thyroxine therapy, 2/32 (6 %) patients significantly decreased doses of thyrostatic drugs. In 2/32 (6 %) patients the treatment was ineffective. The effect of the treatment did not depend on the etiology and severity of hyperthyroidism, but decreased with thyroid volume. Patients with ineffective or only partially effective treatment had median of thyroid volume more than 40 ml. In 1 patient thyroid associated ophthalmopathy was moderately worsened. Other complications were not observed. If we compared financial costs in model with 1 patient, we found that the costs of radioiodine therapy on an outpatient basis (118.7 €) comprise only 16 % of the costs of radioiodine therapy in hospitalization (728 €) and only 25 % of the costs of surgery (475.6 €).

Conclusion:
Radioiodine ¹³¹I is effective and safe in the treatment of hyperthyroidism and the therapy on an outpatient basis is much cheaper choice. The therapy with ¹³¹I on an outpatient basis is not suitable in patients with thyroid volume more than 40 ml.

Key words:
hyperthyroidism – radioiodine ¹³¹I – financial costs

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