A long-term study evaluated the quality of life (QoL) in patients 6-10 years after treatment for Graves’ disease (GD) using a health status survey. The study compared outcomes across three common treatment modalities: radioiodine (RAI), thyroidectomy (surgical removal of the thyroid), and antithyroid drugs (ATD). This comprehensive analysis utilized both a thyroid-specific questionnaire (ThyPRO) and a general health status survey (36-item Short Form Health Status) to assess the impact of each treatment on patients’ overall well-being.
Long-Term Quality of Life After Graves’ Disease Treatment
The study included 1186 GD patients treated at seven different centers. Participants completed either the ThyPRO (n=975) or the 36-item Short Form Health Status survey (n=964) 6-10 years after their initial diagnosis. The results were then compared to data from a general population sample (n=712) to determine the long-term impact of GD and its treatments on QoL. Statistical adjustments were made for age, sex, number of treatments, comorbidity, and potential multiple testing effects.
Radioiodine Treatment Associated with Lower Quality of Life Scores
The health status survey revealed that, regardless of the treatment method, individuals with GD experienced a lower QoL compared to the general population years after diagnosis. However, a key finding emerged: patients treated with RAI consistently reported worse thyroid-related and general QoL than those treated with ATD or thyroidectomy across most scales. This observation held true even after adjusting for various confounding factors. Sensitivity analyses further confirmed the negative impact of RAI on QoL in this patient cohort.
Study Limitations and Future Research
While this study provides valuable insights, it has limitations. The comparison group was drawn from a different country (Denmark), potentially introducing cultural differences in QoL perception. Additionally, patients treated with RAI tended to be older and may have had a longer disease duration before treatment, potentially influencing outcomes. Finally, the study lacked information on participants’ thyroid status at the time of the QoL assessment, a factor that could affect results.
Conclusion: Implications for Treatment Decisions
This large-scale study indicates that a health status survey reveals RAI treatment for GD may be associated with long-term negative effects on QoL. While previous smaller studies found no significant differences in patient satisfaction between treatments, these findings suggest a need for further investigation into the impact of RAI. Future research should focus on understanding the mechanisms by which RAI might affect QoL and confirm these findings in other populations. This information is crucial for clinicians and patients when making informed decisions about the most appropriate treatment approach for GD.
