long term use of carbimazole

[shimself]

It's commonly written that it is undesirable to use carbimazole long term (say >2years). But all my readings say that problems arise within months of first use, indeed I haven't found even one case report.

Other than in the most general terms (ie it's not good to take a drug if you don't have to), what's the problem please?

[Professor John Lazarus]

you are generally correct but sometimes side effects do occur late in the treatment.
The other point is that when patients are on long term carbimazole any problem they might get is assumed to be realted to the drug and this is often not the case. Also patients increase and decrease the dose when there is no indication and this may cause confusion in the tests etc.
However, some patients do very well on long term therapy butit still leaves open the question of relapse of the disease.

[shimself]

Thanks for the reply.

There are 2 studies published recently which appear to show that relapse is more likely if carbimazole is discontinued too soon. 1 with a blocking dose, 1 with a lower (titrating?) dose. In my case (GO/TED), where antibodies are still present 3 years after I presented, I'm keen to go along this route rather than thyroidectomy (and I don't really see much convincing evidence that thyroidectomy is likely to do me much good anyway).

The studies are Laurberg et al DOI: 10.1089/thy.2011.0039 and Elbers et al DOI: 10.1089/thy.2010.0181


Steve