**4. Future therapies**

Although antithyroid drugs, radioactive iodine and surgery have been the treatment options in the las few decades, in recent years treatment options based on immunobiology such as biologics, small molecules and peptide immunomodulation have been investigated. These treatments are in different stages of development and are aimed at immunomodulation of B lymphocytes such as rituximab, iscalimab and belimumab, blocking of immunoglobulin recycling, signaling of TSH receptors as antagonists of TSH receptor, immune tolerance as immunomodulatory TSH receptor peptides, with the benefit of a lower risk of toxicity and since they are targeted treatments, a lower risk of immunosuppression and the hope of higher rates of remission [42].
