The potential interaction between medical treatment and radioiodine treatment success: A systematic review

source extracted confidence: high 2026-04-09
#humans #antithyroid-agents #iodine-radioisotopes #lithium #prednisone

The potential interaction between medical treatment and radioiodine treatment success: A systematic review

Zannat et al., 2022 | Front Endocrinol (Lausanne) | Meta Analysis

Citation

Zannat Riazul, Lee Jonathan, ... Nieto Hannah R. The potential interaction between medical treatment and radioiodine treatment success: A systematic review. Front Endocrinol (Lausanne). 2022;13:1061555. doi:10.3389/fendo.2022.1061555

Abstract

INTRODUCTION: Radioactive iodine (RAI) therapy is a critical component in the post-surgical management of thyroid cancer patients, as well as being a central therapeutic option in the treatment of hyperthyroidism. Previous work suggests that antithyroid drugs hinder the efficacy of RAI therapy in patients. However, the effects of other background medications on RAI treatment efficacy have not been evaluated. Therefore, we performed a systematic review and meta-analysis investigating the potential off-target effects of medication on RAI therapy in patients with thyroid cancer and hyperthyroidism. METHODS: Systematic review and meta-analysis according to the 2020 PRISMA guidelines. Databases searched: MEDLINE, EMBASE and Cochrane Library for studies published between 2001 and 2021. RESULTS: Sixty-nine unique studies were identified. After screening, 17 studies with 3313 participants were included. One study investigated thyroid cancer, with the rest targeted to hyperthyroidism. The majority of studies evaluated the effects of antithyroid drugs; the other drugs studied included lithium, prednisone and glycididazole sodium. Antithyroid drugs were associated with negative impacts on post-RAI outcomes (n = 5 studies, RR = 0.81, p = 0.02). However, meta-analysis found moderate heterogeneity between studies (I2 = 51%, τ2 = 0.0199, p = 0.08). Interestingly, lithium (n = 3 studies), prednisone (n = 1 study) and glycididazole (n = 1 study) appeared to have positive impacts on post-RAI outcomes upon qualitative analysis. CONCLUSION: Our systematic review strengthens previous work on antithyroid medication effects on RAI, and highlights that this field remains under researched especially for background medications unrelated to thyroid disease, with very few papers on non-thyroid medications published. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/display_record.php, identifier CRD42021274026.

Key Findings

Sixty-nine unique studies were identified. After screening, 17 studies with 3313 participants were included. One study investigated thyroid cancer, with the rest targeted to hyperthyroidism. The majority of studies evaluated the effects of antithyroid drugs; the other drugs studied included lithium, prednisone and glycididazole sodium. Antithyroid drugs were associated with negative impacts on post-RAI outcomes (n = 5 studies, RR = 0.81, p = 0.02). However, meta-analysis found moderate heterogen

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population thyroid cancer and hyperthyroidism
Sample Size 5
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Antithyroid Agents
  • Iodine Radioisotopes
  • Lithium
  • Prednisone
  • Thyroid Neoplasms
  • Hyperthyroidism
  • Treatment Outcome

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Meta-Analysis, Systematic Review, Journal Article, Research Support, Non-U.S. Gov't
  • Vertical: iodine

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09