Positive Impact of Long-Term Antithyroid Drug Treatment on the Outcome of Children with Graves' Disease: National Long-Term Cohort Study

Abstract

About half the patients achieved remission after carbimazole discontinuation, and there seems to be a plateau in the incidence of remission achieved after 8-10 yr ATD therapy.

Management of thyrotoxicosis in children and adolescents: 35 years’ experience in 304 patients

“…There is some controversy on the use of MMI as a first-line treatment of pediatric hyperthyroidism and we used, similar to other studies, methimazole as the first-line therapy in all patients [19,20,[22][23][24][25]. Remission rates after ATD withdrawal varied in different studies ranging from 33% to 64% [6,23,26].…”

“…Another prospective study showed that relapse risk of hyperthyroidism decreased with the duration of the first course of ATD and every additional year of ATD therapy was associated with a decrease in the relapse rate [20]. Another study evaluated the effect of the duration of ATD treatment after three consecutive courses, each lasting for 2 years and found a remission rate of 50% after discontinuation of ATD treatment [24]. We did not study the relapse rate of hyperthyroidism following discontinuation of long-term ATD treatment.…”

“…On the other hand, many patients continue ATD, after relapse, fearing occurrence of complications of radioiodine treatment and thyroidectomy. Little is known about the long-term treatment with ATD, as only a few studies have been reported regarding the outcome of continuous ATD and of the relationship between ATD treatment duration and remission or relapse in children and adolescents with hyper thyroidism [19,20,24].…”

Radioiodine therapy of thyrotoxicosis in children and adolescents. Indications, efficacy and safety. Literature review

“…Максимальные сроки лечения тиреостатиками у детей и подростков не определены, но большин-ство авторов склоняются к 12-18 мес, мак-симум 2 года. В случае развития осложне-ний отсутствие эффекта на фоне лечения и рецидив тиреотоксикоза являются показа-ниями для смены тактики лечения с выбо-ром радио йодтерапии (РЙТ) или тиреоид-эктомии [1,10]. Отсутствие значительного снижения уровня антител к рецептору тирео-тропного гормона после РЙТ, высокий уро-вень тиреоидных гормонов в крови, размер ЩЖ более 80 мл, а также наличие тиреоток-сикоза более чем через 3 мес после РЙТ явля ются предикторами неэффективности РЙТ [6,10,11].…”

Increasing use of radioiodine in young people with thyrotoxicosis in Great Britain

“…Data from Europe and North America have shown that short-term side effects such as thyroid storm are uncommon following RI administration in patients with thyrotoxicosis and the low additional radiation exposure during therapy has not resulted in a measurable overall increase in long-term neoplasia, or other adverse effects, to date (1,2). This information is of considerable potential value to paediatric endocrinologists because a 2-to 4-year course of anti-thyroid drugs will only result in remission in a minority of patients (2,3). Although anecdotal evidence suggests that some paediatric endocrinologists in the UK now consider RI to be a safe and effective alternative to surgery in young patients with thyrotoxicosis, there is as yet no formal strategy in Great Britain to collect longerterm data on RI usage in the young or to study any potential long-term consequences of these exposures on health.…”