PMID- 31040197
OWN - NLM
STAT- MEDLINE
DCOM- 20191114
LR  - 20191114
IS  - 1098-4275 (Electronic)
IS  - 0031-4005 (Linking)
VI  - 143
IP  - 5
DP  - 2019 May
TI  - Long-term Methimazole Therapy in Juvenile Graves' Disease: A Randomized Trial.
LID - e20183034 [pii]
LID - 10.1542/peds.2018-3034 [doi]
AB  - BACKGROUND AND OBJECTIVES: Recent studies show that long-term (LT) antithyroid 
      drugs reduce relapse of hyperthyroidism in patients with Graves' disease. Our 
      objective was to evaluate the effectiveness and safety of LT methimazole 
      treatment and to compare remission rates in Graves' disease patients after LT and 
      short-term (ST) therapy. METHODS: In this randomized, parallel group trial, 66 
      consecutive patients with untreated juvenile Graves' hyperthyroidism were 
      enrolled. After a median 22 months of methimazole treatment, 56 patients were 
      randomly assigned to either continue low-dose methimazole treatment (n = 24, LT 
      group) or to discontinue treatment (n = 24, ST group). Twenty-four patients in LT 
      group completed 96 to 120 months of methimazole treatment. Patients in both 
      groups were managed for 48 months after discontinuation of treatment. RESULTS: 
      Except for 3 cases of cutaneous reactions, no other adverse events were observed 
      throughout 120 months of methimazole therapy. Serum free thyroxine, 
      triiodothyronine, thyrotropin, and thyrotropin receptor antibody remained normal, 
      and the required daily dosage of methimazole was gradually decreased from 5.17 +/- 
      1.05 mg at 22 months to 3.5 +/- 1.3 mg between 96 and 120 months of treatment (P < 
      .001). Hyperthyroidism was cured in 92% and 88% of LT patients and in 46% and 33% 
      of ST patients, 1 and 4 years after methimazole withdrawal, respectively. 
      CONCLUSIONS: LT methimazole treatment of 96 to 120 months is safe and effective 
      for treatment of juvenile Graves' disease. The four-year cure rate of 
      hyperthyroidism with LT methimazole treatment is almost 3 times more than that of 
      ST methimazole treatment.
CI  - Copyright (c) 2019 by the American Academy of Pediatrics.
FAU - Azizi, Fereidoun
AU  - Azizi F
AD  - Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid 
      Beheshti University of Medical Sciences, Tehran, Iran; and.
FAU - Takyar, Miralireza
AU  - Takyar M
AD  - Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid 
      Beheshti University of Medical Sciences, Tehran, Iran; and.
FAU - Madreseh, Elham
AU  - Madreseh E
AD  - Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid 
      Beheshti University of Medical Sciences, Tehran, Iran; and.
AD  - Department of Epidemiology and Biostatistics, School of Public Health, Tehran 
      University of Medical Sciences, Tehran, Iran.
FAU - Amouzegar, Atieh
AU  - Amouzegar A
AD  - Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid 
      Beheshti University of Medical Sciences, Tehran, Iran; and 
      amouzegar@endocrine.ac.ir.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - Pediatrics
JT  - Pediatrics
JID - 0376422
RN  - 0 (Antithyroid Agents)
RN  - 554Z48XN5E (Methimazole)
SB  - IM
MH  - Adolescent
MH  - Antithyroid Agents/*administration & dosage
MH  - Drug Administration Schedule
MH  - Female
MH  - Graves Disease/blood/*diagnosis/*drug therapy
MH  - Humans
MH  - Male
MH  - Methimazole/*administration & dosage
MH  - Thyroid Function Tests/trends
COIS- POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential 
      conflicts of interest to disclose.
EDAT- 2019/05/02 06:00
MHDA- 2019/11/15 06:00
CRDT- 2019/05/02 06:00
PHST- 2019/02/25 00:00 [accepted]
PHST- 2019/05/02 06:00 [entrez]
PHST- 2019/05/02 06:00 [pubmed]
PHST- 2019/11/15 06:00 [medline]
AID - peds.2018-3034 [pii]
AID - 10.1542/peds.2018-3034 [doi]
PST - ppublish
SO  - Pediatrics. 2019 May;143(5):e20183034. doi: 10.1542/peds.2018-3034.