Systematic review of131I combined with lithium carbonate and 131I alone in the treatment of hyperthyroidism

Abstract:

Objective: To evaluate whether¹³¹I combined with lithium carbonate is better than¹³¹I alone in the treatment of hyperthyroidism. Methods: The literature published before April 2020 in PubMed, Web of Science, the Cochrane Library, CNKI, CBM and Wanfang databases was retrieved. Randomized controlled trials (RCTs) of¹³¹I combined with lithium carbonate and¹³¹I alone in the treatment of hyperthyroidism were searched. The risk bias evaluation tool recommended by Cochrane system evaluation manual was used to evaluate the quality of the included literature, and Review Manager 5.3 was used to perform Meta-analysis on the extracted data, while descriptive analysis was used for those that could not be combined. Results: This study included 14 RCTs for analysis, including 1 567 patients, 808 in the experimental group and 759 in the control group. The results showed that there was significant difference in the cure rate of hyperthyroidism between¹³¹I combined with lithium carbonate and¹³¹I alone at the third month (RR=1.24, 95% CI=1.09-1.41, P=0.001) and 12th month (RR=1.18, 95% CI=1.04-1.34, P=0.010). There was significant difference in the recurrence rate of hyperthyroidism at the third month (RR=0.39, 95% CI=0.18-0.85, P=0.02), and the incidence of hypothyroidism in one month (RR=1.39, 95% CI=1.06-1.84, P=0.02), and no significant difference in the total effective rate of hyperthyroidism treatment at the third month (RR=1.02, 95% CI=0.97-1.08, P=0.48) and sixth month (RR=1.06, 95% CI=0.86-1.30, P=0.60). There was no significant difference in thyroid size at 1 month (SMD=-0.26, 95% CI=-0.61-0.09, P=0.15). Conclusion: The results of systematic review show that¹³¹I combined with lithium carbonate in the treatment of hyperthyroidism, the cure rate, recurrence rate of hyperthyroidism in the third and 12th month and the incidence of hypothyroidism in the 12th month are better than those of¹³¹I alone, but there is no significant difference in the total effectiverateandthyroidsizeof hyperthyroidism treatment. However, due to the low quality of the included literature, its results and conclusions still need to be verified by more RCTs with large samples, multi centers, and test design specifications.