No coin nor oath required. For personal study only.
Aims: Multinodular goitre (MNG) is a common clinical finding, particularly in females, and is usually asymptomatic. When symptoms occur due to local pressurerelated effects the only treatment is surgical with thyroidectomy. A number of epidemiological observations and experimental data have suggested that oestrogen aromatase activity may be involved in the pathogenesis of MNG. This study examines the effect of anastrozole, a non-steroidal aromatase inhibitor that inhibits the peripheral conversion of testosterone to oestradiol, in reducing the size of MNG. Methods: Between December 2001 and October 2002, 32 postmenopausal female patients, median age 63 (range, 42-84) years, were prospectively entered into the trial. The patients were randomised in a double-blind fashion to receive either anastrozole 1 mg daily or placebo for 3 months. Ultrasonographic measurement of each thyroid lobe together with complete biochemical and hormone profiles were performed at the start and end of treatment. Full ethics committee approval was obtained. Results: Twenty-eight patients completed the study; one patient underwent total thyroidectomy, one patient withdrew and two were lost to follow-up. There was no significant reduction in the goitre size for patients in the anastrozole group (P = 0•246) or the placebo group (P = 0•418). There were no significant changes in hormone profiles within each group at the start and end of the study. Nineteen patients reported minor side effects, seven of which were in the placebo group. Conclusions: The use of anastrozole in the treatment of MNG does not appear to have any effect in reducing the size of multinodular goitre.
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