[Samitin]

Текущего года UpToDate ссылается даже на чуть более раннюю, но весьма аккуратную публикацию
Impact of lithium on efficacy of radioactive iodine therapy for Graves' disease: a cohort study on cure rate, time to cure, and frequency of increased serum thyroxine after antithyroid drug withdrawal.

Bogazzi F, Giovannetti C, Fessehatsion R, Tanda ML, Campomori A, Compri E, Rossi G, Ceccarelli C, Vitti P, Pinchera A, Bartalena L, Martino E

J Clin Endocrinol Metab. 2010;95(1):201. Epub 2009 Nov 11.

CONTEXTRadioactive iodine (RAI) is a common therapy for hyperthyroidism due to Graves' disease. A small but significant proportion of patients have recurrence of hyperthyroidism after RAI therapy. Lithium might increase RAI effectiveness by increasing RAI retention in the thyroid. However, whether lithium favorably affects the long-term outcome of RAI therapy is still a matter of argument.

OBJECTIVEThe objective of the study was to compare the efficacy of RAI given with or without concomitant lithium treatment.

DESIGNThis was a retrospective cohort study.

SETTINGThe study was conducted at a tertiary university center.

PATIENTSSix hundred fifty-one patients with newly diagnosed Graves' disease participated in the study.

INTERVENTIONTwo hundred ninety-eight patients were treated with RAI plus lithium (900 mg/d for 12 d) and 353 with RAI alone.

MAIN OUTCOME MEASURESProportion of cured patients and time to achieve cure of hyperthyroidism during 1 yr of follow-up was measured.

RESULTSPATIENTS treated with RAI plus lithium had a higher cure rate (91.0%) than those treated with RAI alone (85.0%, P = 0.030). In addition, patients treated with RAI plus lithium were cured more rapidly (median 60 d) than those treated with RAI alone (median 90 d, P = 0.000). Treatment with lithium prevented the serum free T(4) increase after methimazole withdrawal and RAI therapy. Side effects after RAI therapy occurred in a subset of patients and were mild, transient, and without differences in the two groups.

CONCLUSIONS RAI combined with lithium is safe and more effective than RAI alone in the cure of hyperthyroidism due to Graves' disease.

Department of Endocrinology and Metabolism, and Epidemiology and Biostatistics Unit (G.R.), Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy. PMID 19906789

Тут, скорее, не разница в 6% в частоте успеха РЙТ важна, а более быстрое развитие эффекта.