The efficacy and safety of lithium carbonate in combination with radioactive iodine therapy of hyperthyroidism: a meta-analysis and systematic review

Backgroud: Several treatment options are available for patients with hyperthyroidism, such as antithyroid drugs and radioactive iodine. Recently, increasing number of patients with hyperthyroidism take lithium carbonate in combination with radioactive iodine. Numerous clinical studies have been done to evaluate the efficacy and safety of lithium carbonate in combination with radioactive iodine therapy of hyperthyroidism. However, the results are conflicting. The aim of the present study was to evaluate the efficacy and safety of lithium carbonate in combination with radioactive iodine therapy in patients with hyperthyroidism. Methods: Trials were retrieved through Pubmed, Sinomed and China National Knowledge Infrastructure (CNKI). Meta-analysis was used following a random effects model to analysis the data if there was no significant difference in homogeneity among trials. The pooled relative risk (RR) and 95% confidence interval (CI) were used to describe the outcome indicator. Results: Twelve randomized controlled trials were enrolled in the meta-analysis, the twelve clinical trials randomized a total of 1754 patients. The number of people being cured in the test group is 673, the cure rate is 75.53%; while the control group is 552, the cure rate is 63.96% (RR 1.17; 95% CI, 1.11-1.24; P<0.00001). In addition, no severe side effects were observed in the test group. Conclusion: Lithium carbonate in combination with radioactive iodine therapy significantly elevates the cure rate without severe side effects in patients with hyperthyroidism.