Positive impact of long-term antithyroid drug treatment on the outcome of children with Graves’ disease: National long-term cohort study
The Journal of Clinical Endocrinology & Metabolism. 2012-01-01; 97(1): 110-119
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1. J Clin Endocrinol Metab. 2012 Jan;97(1):110-9. doi: 10.1210/jc.2011-1944. Epub
2011 Oct 26.
Positive impact of long-term antithyroid drug treatment on the outcome of
children with Graves’ disease: national long-term cohort study.
Léger J(1), Gelwane G, Kaguelidou F, Benmerad M, Alberti C; French Childhood
Graves’ Disease Study Group.
Collaborators: Coutant R, Montaud-Raguideau N, Bony-Trifunovic H, Bertrand A,
Lucidarme N, Sauvion S, Barat P, Bex-Bachellerie V, Colle M, Puel O, Metz C,
Nivot S, Loeuille G, Kurtz F, Bost M, Charvet J, Nsota J, Pelatan C, Stuckens C,
Naud-Saudreau C, Nicolino M, Tixier F, Arzim M, Raybaud C, Gallet S, Goddon R,
Baron S, Baechler-Sadoul E, Wagner K, Cabrol S, Castanet M, Carel J, Czernichow
P, Esteva B, Houang M, Pinto G, Polak M, Raux-Demay M, Zenaty D, Blanc P,
Boulkessaim K, Louf S, Guitteny M, Lecointre C, Raynaud-Ravni C, Crosnier H, Feki
S, Soskin S, Jesuran-Perelroizen M, Oliver I, Pienkowski C, Tauber M, Despert F,
Degros V, Taghian M, Thierry P.
(1)Assistance Publique-Hopitaux de Paris, Hopital Robert Debré, Service
d’Endocrinologie Pédiatrique, Centre de Référence des Maladies Endocriniennes
Rares de la Croissance, INSERM Unité 676, Hôpital Robert Debré, 48 Boulevard
Sérurier, 75019 Paris, France.
CONTEXT: Drug-based therapy is usually the initial treatment for Graves’ disease
(GD) hyperthyroidism in children, but there is some debate about treatment
OBJECTIVE: Our objective was to assess the effect of long-term carbimazole
therapy on GD remission in children and its determinants.
DESIGN AND SETTING: This was an observational prospective multicenter follow-up
PARTICIPANTS: Participants included 154 children newly diagnosed with GD between
1997 and 2002. The intention was to treat patients with three consecutive courses
of carbimazole, each lasting 2 yr. Definitive treatment was performed in cases of
poor compliance with antithyroid drug (ATD) treatment, thyrotoxicosis relapse, or
major adverse effects of ATD treatment.
MAIN OUTCOME MEASURE: The main outcome measure was remission for at least 18
months after the completion of each course of ATD treatment.
RESULTS: The median duration of follow-up was 10.4 (9.0-12.1) yr. Overall
estimated remission rates (95% confidence interval) 18 months after the
withdrawal of ATD treatment increased with time and were 20 (13-26), 37 (29-45),
45 (35-54), and 49 (40-57)% after 4, 6, 8, and 10 yr follow-up, respectively. A
multivariate competing risk model revealed an independent positive effect of less
severe forms of hyperthyroidism at diagnosis [subhazard ratio of 1 for patients
with free T(4)