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Long Term Treatment of Graves' Disease with Iopanoic Acid (Telepaque)

Department of Medicine, Veterans General Hospital Taichung, Taiwan, Republic of China
Endocrinobgy Section, Wadsworth Veterans Administration Medical Center, University of California School of Medicine Los Angeles, California 90073

Address requests for reprints to: Yuh-Shyun Wang, M.D., Division of Family Medicine, Veterans General Hospital-Taichung, 160 Taichung Harbor Road, Section 3, Taichung, Taiwan 400, Republic of China.

To investigate the long term utility of the cholecystographic contrast agent iopanoic acid (Telepaque) for treatment of Graves' hyperthyroidism, we studied 40 patients treated with 500 mg, orally, daily for 1–12 months. We measured thyroid size; body weight; serum T₃, T₄, and free T₄ concentrations; and antithyroglobulin and antimicrosomal antibody levels at monthly intervals. Based on the effects of the therapy, the patients were divided into 3 groups: 6 patients had excellent responses with return of serum thyroid hormone levels to normal (group A); 12 patients had fair responses, but 1 thyroid hormone test remained elevated (group B); and 22 patients had minimal benefit (group C) with only slight clinical improvement and transient reduction of serum T₃ concentration. Mean serum T₃ levels decreased significantly after 1 month of therapy in all 3 groups and became normal in groups A and B, but the reduction in group C was not sustained. Mean serum T₄ and free T₄ levels remained above normal during the course of therapy in groups B and C. Sixty-eight percent of patients in group C had large goiters compared with 33% of group A and 25% of group B, and those in group C tended to have more severe biochemical hyperthyroidism initially. There were no significant changes in antibody titers during therapy. These data indicate that iopanoic acid is not effective therapy for many hyperthyroid patients.

Received April 16, 1987.

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