JOURNAL ARTICLE

New therapeutic horizons for Graves' hyperthyroidism

Laura C Lane, Tim D Cheetham, Petros Perros, Simon H S Pearce
Endocrine Reviews 2020 August 26
32845332
Graves' hyperthyroidism is characterised by the presence of autoantibodies that stimulate the thyroid stimulating hormone receptor (TSHR), resulting in uncontrolled secretion of excessive thyroid hormone. Conventional treatments including antithyroid medication, radioiodine or surgery have remained largely unchanged for the past 70 years and either lack efficacy for many patients, or result in lifelong thyroid hormone replacement therapy in the case of the latter two options. The demand for new therapeutic options combined with greater insight into basic immunobiology, has led to the emergence of novel approaches to treat Graves' hyperthyroidism. The current therapies under investigation include biologics, small-molecules and peptide immunomodulation. There is a growing focus on TSHR-specific treatment modalities, which carry the advantage of eliciting a specific, targeted approach, with the aim of avoiding disruption of the functioning immune system. These therapies offer the new opportunity to supersede the inadequate treatments currently available for some Graves' patients, with the hope of successful restoration of euthyroidism without the need for ongoing therapy. Several of these therapeutic options have the potential to translate into clinical practice in the near future. This review provides a comprehensive summary of the recent advances and various stages of development of the novel therapeutic approaches to treat Graves' hyperthyroidism.

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Kim Heng Shee

Make a lot of sense and it is one of the great example of precision medicine.

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