5 179 H B Burch and D S Cooper Antithyroid drug therapy: 179:5 R261–R274 Review 70 years later ANNIVERSARY REVIEW Antithyroid drug therapy: 70 years later Henry B Burch1 and David S Cooper2 Correspondence 1National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, should be addressed Maryland, USA and 2Division of Endocrinology, Diabetes, and Metabolism, The Johns Hopkins University School of to D S Cooper Medicine, Baltimore, Maryland, USA Email
[email protected] Abstract The thionamide antithyroid drugs were discovered in large part following serendipitous observations by a number of investigators in the 1940s who found that sulfhydryl-containing compounds were goitrogenic in animals. This prompted Prof. Edwin B Astwood to pioneer the use of these compounds to treat hyperthyroidism in the early 1940s and to develop the more potent and less toxic drugs that are used today. Despite their simple molecular structure and ease of use, many uncertainties remain, including their mechanism(s) of action, clinical role, optimal use in pregnancy and the prediction and prevention of rare but potentially life-threatening adverse reactions. In this review, we summarize the history of the development of these drugs and outline their current role in the clinical management of patients with hyperthyroidism. European Journal of Endocrinology (2018) 179, R261–R274 History Prior to the 1940s, surgery was the only treatment for University School of Medicine, the Mackenzies (2) European Journal European of Endocrinology hyperthyroidism. In 1942, Edwin B Astwood began a series and Richter et al. (3). Both groups showed that certain of investigations at Harvard and later at Tufts Medical substances (sulfaguanidine and phenylthiourea, Schools that would ultimately lead to the development respectively) were goitrogenic.