Methimazole monotherapy versus combination therapy with beta-blockers in hyperthyroidism: a narrative review
DOI:
10.29303/sjp.v7i2.644Downloads
Abstract
Hipertiroidisme merupakan kondisi akibat produksi dan pelepasan hormon tiroid yang berlebihan. Methimazole (MMI) merupakan salah satu obat antitiroid yang digunakan untuk menghambat sintesis hormon tiroid, sedangkan β-blocker digunakan sebagai terapi tambahan untuk mengendalikan manifestasi hiperadrenergik pada hipertiroidisme. Meskipun kedua pendekatan terapi telah banyak diteliti, bukti komparatif mengenai efektivitas MMI monoterapi dan kombinasi MMI dengan beta-blocker masih terbatas. Tinjauan ini dilakukan untuk mengevaluasi efektivitas MMI sebagai monoterapi dibandingkan kombinasi MMI dengan β-blocker dalam pengendalian hipertiroidisme. Tinjauan naratif dilakukan melalui penelusuran artikel pada PubMed dan Google Scholar menggunakan pendekatan PICO. Kriteria artikel yang dipilih meliputi, diterbitkan tahun 2016–2026, tersedia dalam teks lengkap, menggunakan bahasa Indonesia atau Inggris. Outcome yang dianalisis meliputi heart rate (HR), FT3, FT4, dan TSH. Sebanyak 182 artikel teridentifikasi, kemudian setelah proses skrining dan penerapan kriteria inklusi dan eksklusi diperoleh tiga artikel untuk dianalisis. Penilaian risiko bias dilakukan menggunakan ROBINS-I. Tiga studi retrospektif menunjukkan kombinasi methimazole (MMI) dengan beta-blocker memperbaiki fungsi tiroid dan respons terapi dibandingkan monoterapi MMI. Namun, metode terapi tidak berhubungan signifikan dengan ketidakefektifan terapi, dan salah satu studi memiliki risiko bias yang serius. Kombinasi methimazole (MMI) dengan β-blocker menunjukkan perbaikan parameter fungsi tiroid dan respons terapi dibandingkan monoterapi MMI. Namun, bukti yang tersedia masih terbatas pada studi retrospektif sehingga diperlukan penelitian dengan desain yang lebih kuat.
Keywords:
antitiroid, beta-blocker, efektivitas terapi, hipertiroidisme, methimazole, propranololReferences
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