A 38-year-old woman with Graves' disease is started on methimazole. After 6 weeks, her thyroid function normalises. According to current ATA guidelines, what is the recommended total duration of anti-thyroid drug therapy before considering discontinuation and testing for remission?
- A 6 months
- B 12–18 months ✓
- C 3 months
- D 36 months
Correct answer: B. 12–18 months
Explanation
The 2016 ATA Guidelines for Hyperthyroidism recommend continuing anti-thyroid drugs for 12–18 months before attempting discontinuation in Graves' disease, as longer treatment durations are associated with higher rates of remission. Remission is predicted by normalization of TSH-receptor antibodies (TRAb) at the time of discontinuation. A 6-month course yields lower remission rates (~30–40%), while 12–18 months achieves roughly 50–55% remission.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.