Endocrinologie-enfant.net Contents / Edition 55 - 2015, September

Contents of “Endocrinologie et Développment de L’enfant”: Basedow´s disease in Pediatrics: long-term follow up of a French National Cohort – Ed. 55

ENDOCRINOLOGIE-ENFANT WEB PAGE

A Seminar uploaded in the French webpage www.endocrinologie-enfant.net, by Léger et al., has been translated (with the author´s authorization) from French to Spanish (see Spanish version in the present issue of endopedonline). The study had been previously published by Léger et al. in the J Clin Endocrinol Metab 2012 (97: 110 –119).

The Abstract of this publication follows:

 

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

Juliane Legér, Georges Gelwane, Florentia Kaguelidou, Meriem Benmerad, Corinne Alberti, and the French Childhood Graves’ Disease Study Group.

Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Service d’Endocrinologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance (J.L., G.G.), and Unité d’Epidémiologie Clinique (C.A.); Institut National de la Santé et de la Recherche Médicale (INSERM) Unité Mixte de Recherche 676 (J.L.); INSERM Centre d’Investigation Epidémiologique 5 (F.K., M.B., C.A.); and Université Paris Diderot (J.L., F.K., C.A.), Sorbonne Paris Cité, Paris, 75019, France

ABSTRACT:

Context: Drug-based therapy is usually the initial treatment for Graves’ disease (GD) hyperthyroidism in children, but there is some debate about treatment duration. 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 cohort study. 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 T4 Conclusion: 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.(J Clin Endocrinol Metab 97: 110 –119, 2012).


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