For more than 70 years, thionamide compounds have been used in the treatment of hyperthyroidism and helped to reduce the burden of comorbidities and mortality in these patients. Three thionamide antithyroid drugs are available; methimazole, its prodrug carbimazole (hereafter methimazole refers to both drugs) and propylthiouracil. Methimazole and propylthiouracil are generally well tolerated but serious adverse effects, such as agranulocytosis and drug-induced liver injury, occur in 0·5–1·0% of users. Based on an overall evaluation of efficacy, convenience in dosing, and a favourable side-effect profile, methimazole has become the most commonly used antithyroid drug worldwide. In January, 2019, acute pancreatitis was added to the list of potential adverse drug reactions to methimazole. This decision was based on six case reports of acute pancreatitis in patients treated with methimazole. Although a population-based case-control study did not find such an association, the European Medicines Agency (EMA) issued a warning for the drug and the product labelling for methimazole was changed to include acute pancreatitis as a serious side effect. No data are available regarding use of propylthiouracil and risk of acute pancreatitis. If risk of developing acute pancreatitis is increased with methimazole, but not with propylthiouracil, drug preference among both patients and clinicians could potentially be affected.

中文翻译：

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甲基咪唑和急性胰腺炎的风险。

70多年来，亚硫酰胺化合物已用于治疗甲状腺功能亢进症，并有助于减轻这些患者的合并症负担和死亡率。可以使用三种亚硫酰胺抗甲状腺药。甲巯咪唑，其前药咔咪唑（以下称甲巯咪唑是指两种药物）和丙基硫氧嘧啶。甲基咪唑和丙基硫尿嘧啶通常耐受性良好，但严重的不良反应（如粒细胞缺乏症和药物引起的肝损伤）发生在0·5-1–0％的使用者中。基于对功效，给药方便性和良好副作用的总体评估，甲他唑已成为全球最常用的抗甲状腺药物。在2019年1月，急性胰腺炎被添加到对甲巯咪唑的潜在不良药物反应清单中。这项决定是基于6例甲巯咪唑治疗的急性胰腺炎病例报告。尽管基于人群的病例对照研究没有发现这种关联，但欧洲药品管理局（EMA）对该药物发出了警告，并将甲巯咪唑的产品标签更改为包括急性胰腺炎，这是严重的副作用。没有关于丙硫氧嘧啶的使用和急性胰腺炎风险的数据。如果使用甲巯咪唑而不是使用丙硫氧嘧啶增加患急性胰腺炎的风险，则可能会影响患者和临床医生的药物偏爱。欧洲药品管理局（EMA）对该药物发出了警告，并更改了甲巯咪唑的产品标签，将急性胰腺炎列为严重副作用。没有关于丙硫氧嘧啶的使用和急性胰腺炎风险的数据。如果使用甲巯咪唑而不是使用丙硫氧嘧啶增加患急性胰腺炎的风险，则可能会影响患者和临床医生的药物偏爱。欧洲药品管理局（EMA）对该药物发出了警告，并更改了甲巯咪唑的产品标签，将急性胰腺炎列为严重副作用。没有关于丙硫氧嘧啶的使用和急性胰腺炎风险的数据。如果使用甲巯咪唑而不是使用丙硫氧嘧啶增加患急性胰腺炎的风险，则可能会影响患者和临床医生的药物偏爱。